Sample records for york-presbyterian hospital nyph

  1. NewYork-Presbyterian Hospital: translating innovation into practice.

    PubMed

    Johnson, Trudy; Currie, Gail; Keill, Patricia; Corwin, Steven J; Pardes, Herbert; Cooper, Mary Reich

    2005-10-01

    NewYork-Presbyterian (NYP) Hospital, a 2,242-bed not-for-profit academic medical center, was formed by a merger of The New York Hospital and The Presbyterian Hospital in the City of New York. It is also the flagship for the NewYork-Presbyterian Healthcare System, with 37 acute care facilities and 18 others. The hospital embeds safety in the culture through strategic initiatives and enhances service and efficiency using Six Sigma and other techniques to drive adoption of improvements. Goals are selected in alignment with the annual strategic initiatives, which are chosen on the basis of satisfaction surveys, patient and family complaints, community advisory groups, and performance measures, among other sources. A new business intelligence system enables online, dynamic analysis of performance results, replacing static paper reports. Advanced features in the clinical information systems include computerized physician order entry; interactive clinical alerts for decision support; a real-time infection control tracking system; and a clinical data warehouse supporting data mining and analysis for quality improvement, decision making, and education. To achieve clinical, service, and operational excellence, NYP focuses on all Institute of Medicine quality aims.

  2. Managing the Alert Process at NewYork-Presbyterian Hospital

    PubMed Central

    Kuperman, Gilad J; Diamente, Rosanna; Khatu, Vrinda; Chan-Kraushar, Terri; Stetson, Pete; Boyer, Aurelia; Cooper, Mary

    2005-01-01

    Clinical decision support can improve the quality of care, but requires substantial knowledge management activities. At NewYork-Presbyterian Hospital in New York City, we have implemented a formal alert management process whereby only hospital committees and departments can request alerts. An explicit requestor, who will help resolve the details of the alert logic and the alert message must be identified. Alerts must be requested in writing using a structured alert request form. Alert requests are reviewed by the Alert Committee and then forwarded to the Information Systems department for a software development estimate. The model required that clinical committees and departments become more actively involved in the development of alerts than had previously been necessary. In the 12 months following implementation, 10 alert requests were received. The model has been well received. A lot of the knowledge engineering work has been distributed and burden has been removed from scarce medical informatics resources. PMID:16779073

  3. Implementing a patient safety and quality program across two merged pediatric institutions.

    PubMed

    Abramson, Erika; Hyman, Daniel; Osorio, S Nena; Kaushal, Rainu

    2009-01-01

    Academic centers are among the health care organizations that have used consolidation as a strategy to improve efficiency and reduce costs. In 1997, the New York Hospital and The Presbyterian Hospital underwent a full-asset merger to become New York City's largest medical center, known as the New York-Presbyterian Hospital (NYPH). In 2006, recognition of the challenges of the Children's Service Line at NYPH led to the formation of a Patient Safety and Quality Program to deliver consistently safe and effective health care. Each campus has a children's quality council, an interdisciplinary group that discusses and prioritizes safety and quality issues. The quality councils from each campus report directly to a bicampus children's quality steering committee formed to ensure that similar safety practices and standards are implemented across both children's hospitals. A safety subcommittee, which primarily coordinates and follows up on leadership safety walk rounds, and a significant-events subcommittee, which reviews morbidities and mortalities, report to each hospital's quality council. The bicampus pediatric quality and safety program is organized around five broad themes: improving the culture of safety, reducing the frequency of health care-acquired infections, reducing harm in the health care setting, using information technology to improve the quality and safety of care provided to patients and families, and measuring the effectiveness of care in key areas. Two sample initiatives--building family engagement and prevention of adverse medication events--illustrate the program's successes and challenges. Developing a pediatric safety and quality program across two campuses has been challenging but has led to important improvements at both organizations.

  4. Branding. Presbyterian Hospital of Dallas, TX.

    PubMed

    2006-01-01

    To help position Presbyterian Hospital of Dallas as a referral center rather than a large community hospital, the facility launched an aggressive multiphase campaign, with Phase I already underway as of April. By using real-life patient testimonials to highlight procedures, technologies, and services not offered by competitors, the effort hopes to increase brand recognition in the Dallas area.

  5. Terminology tools: state of the art and practical lessons.

    PubMed

    Cimino, J J

    2001-01-01

    As controlled medical terminologies evolve from simple code-name-hierarchy arrangements, into rich, knowledge-based ontologies of medical concepts, increased demands are placed on both the developers and users of the terminologies. In response, researchers have begun developing tools to address their needs. The aims of this article are to review previous work done to develop these tools and then to describe work done at Columbia University and New York Presbyterian Hospital (NYPH). Researchers working with the Systematized Nomenclature of Medicine (SNOMED), the Unified Medical Language System (UMLS), and NYPH's Medical Entities Dictionary (MED) have created a wide variety of terminology browsers, editors and servers to facilitate creation, maintenance and use of these terminologies. Although much work has been done, no generally available tools have yet emerged. Consensus on requirement for tool functions, especially terminology servers is emerging. Tools at NYPH have been used successfully to support the integration of clinical applications and the merger of health care institutions. Significant advancement has occurred over the past fifteen years in the development of sophisticated controlled terminologies and the tools to support them. The tool set at NYPH provides a case study to demonstrate one feasible architecture.

  6. PalmCIS: A Wireless Handheld Application for Satisfying Clinician Information Needs

    PubMed Central

    Chen, Elizabeth S.; Mendonça, Eneida A.; McKnight, Lawrence K.; Stetson, Peter D.; Lei, Jianbo; Cimino, James J.

    2004-01-01

    Wireless handheld technology provides new ways to deliver and present information. As with any technology, its unique features must be taken into consideration and its applications designed accordingly. In the clinical setting, availability of needed information can be crucial during the decision-making process. Preliminary studies performed at New York Presbyterian Hospital (NYPH) determined that there are inadequate access to information and ineffective communication among clinicians (potential proximal causes of medical errors). In response to these findings, the authors have been developing extensions to their Web-based clinical information system including PalmCIS, an application that provides access to needed patient information via a wireless personal digital assistant (PDA). The focus was on achieving end-to-end security and developing a highly usable system. This report discusses the motivation behind PalmCIS, design and development of the system, and future directions. PMID:14527976

  7. Geothermal heat for Presbyterian Intercommunity Hospital and Klamath County Nursing Home

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Howard, R.L.; Hubbard, K.; Rosecrans, D.

    The geology and hydrology of the Klamath Falls area is discussed briefly. The geothermal heating system which serves the Presbyterian Intercommunity Hospital and the Klamath County Nursing Home is shown in photographs and schematic drawing. The system consists basically of a well, settling tank, various heat exchangers, pumps, piping, and controls to move the water. From the heat exchangers system water is pumped to the terminal units, where it is used for space heating, domestic hot water, and a glycol snow melting system. The operation of the various parts of the system is described. (MHR)

  8. Adapting current Arden Syntax knowledge for an object oriented event monitor.

    PubMed

    Choi, Jeeyae; Lussier, Yves A; Mendoça, Eneida A

    2003-01-01

    Arden Syntax for Medical Logic Module (MLM)1 was designed for writing and sharing task-specific health knowledge in 1989. Several researchers have developed frameworks to improve the sharability and adaptability of Arden Syntax MLMs, an issue known as "curly braces" problem. Karadimas et al proposed an Arden Syntax MLM-based decision support system that uses an object oriented model and the dynamic linking features of the Java platform.2 Peleg et al proposed creating a Guideline Expression Language (GEL) based on Arden Syntax's logic grammar.3 The New York Presbyterian Hospital (NYPH) has a collection of about 200 MLMs. In a process of adapting the current MLMs for an object-oriented event monitor, we identified two problems that may influence the "curly braces" one: (1) the query expressions within the curly braces of Arden Syntax used in our institution are cryptic to the physicians, institutional dependent and written ineffectively (unpublished results), and (2) the events are coded individually within a curly braces, resulting sometimes in a large number of events - up to 200.

  9. Using IT to improve quality at NewYork-Presybterian Hospital: a requirements-driven strategic planning process.

    PubMed

    Kuperman, Gilad J; Boyer, Aurelia; Cole, Curt; Forman, Bruce; Stetson, Peter D; Cooper, Mary

    2006-01-01

    At NewYork-Presbyterian Hospital, we are committed to the delivery of high quality care. We have implemented a strategic planning process to determine the information technology initiatives that will best help us improve quality. The process began with the creation of a Clinical Quality and IT Committee. The Committee identified 2 high priority goals that would enable demonstrably high quality care: 1) excellence at data warehousing, and 2) optimal use of automated clinical documentation to capture encounter-related quality and safety data. For each high priority goal, a working group was created to develop specific recommendations. The Data Warehousing subgroup has recommended the implementation of an architecture management process and an improved ability for users to get access to aggregate data. The Structured Documentation subgroup is establishing recommendations for a documentation template creation process. The strategic planning process at times is slow, but assures that the organization is focusing on the information technology activities most likely to lead to improved quality.

  10. Using IT to Improve Quality at NewYork-Presybterian Hospital: A Requirements-Driven Strategic Planning Process

    PubMed Central

    Kuperman, Gilad J.; Boyer, Aurelia; Cole, Curt; Forman, Bruce; Stetson, Peter D.; Cooper, Mary

    2006-01-01

    At NewYork-Presbyterian Hospital, we are committed to the delivery of high quality care. We have implemented a strategic planning process to determine the information technology initiatives that will best help us improve quality. The process began with the creation of a Clinical Quality and IT Committee. The Committee identified 2 high priority goals that would enable demonstrably high quality care: 1) excellence at data warehousing, and 2) optimal use of automated clinical documentation to capture encounter-related quality and safety data. For each high priority goal, a working group was created to develop specific recommendations. The Data Warehousing subgroup has recommended the implementation of an architecture management process and an improved ability for users to get access to aggregate data. The Structured Documentation subgroup is establishing recommendations for a documentation template creation process. The strategic planning process at times is slow, but assures that the organization is focusing on the information technology activities most likely to lead to improved quality. PMID:17238381

  11. An Emergency Simulation Course in a Postdoctoral General Dentistry Program: The New York Presbyterian/Weill Cornell Medicine Experience.

    PubMed

    Rubin, Marsha E; Hansen, Heidi J

    2017-11-01

    Dentists can encounter life-threatening medical emergencies during the provision of routine dental care and must therefore be comfortable with the management of these emergencies. High-fidelity simulation has been used routinely in medical and surgical training and is a recognized and effective educational and assessment tool. The aim of this study was to develop and evaluate a new high-fidelity simulation training course in medical emergency management for residents in the General Practice Residency program at New York Presbyterian/Weill Cornell Medicine. In academic years 2014-16, first-year GPR residents were required to take a simulation course covering medical emergency scenarios that are commonly encountered in the dental office. The course involved a team approach to emergency management with active participation by faculty and residents and with each training session followed by feedback and a formal review of the emergencies covered. Evaluation was achieved through completion of questionnaires by the residents following each session. A total of 14 residents (seven in each year) participated, completing 78 questionnaires in the two-year period. They gave the course an overall rating of 4.91 on a scale from 1 to 5, indicating strong agreement with the utility of the course as a learning tool in medical emergency management training. This course is now fully integrated into the GPR educational program at this institution and is a successful component of the emergency medicine curriculum.

  12. 26. 'CITY HOSPITAL, BLACKWELL'S ISLAND.' (Source: New York City Department ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    26. 'CITY HOSPITAL, BLACKWELL'S ISLAND.' (Source: New York City Department of Public Finance, Real Estate Owned by the City of New York under Jurisdiction of the Department of Public Charities, 1909.) - Island Hospital, Roosevelt Island, New York County, NY

  13. Septoplasty - discharge

    MedlinePlus

    ... Elsevier; 2016:chap 27. Read More Rhinoplasty Septoplasty Review Date 1/15/2017 Updated by: Ashutosh Kacker, ... Otolaryngologist, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by ...

  14. Exploring the Geography of America's Religious Denominations: A Presbyterian Example

    ERIC Educational Resources Information Center

    Heatwole, Charles A.

    1977-01-01

    The historically sectional nature of the Presbyterian Church is examined as a case study which illustrates how study of the geography of religious groups can be applied at various academic levels. (AV)

  15. Implementing Legislation to Improve Hospital Support of Breastfeeding, New York State, 2009-2013.

    PubMed

    Dennison, Barbara A; Hawke, Bethany A; Ruberto, Rachael A; Gregg, Deborah J

    2015-07-30

    Increasing breastfeeding is a public health priority supported by strong evidence. In 2009, New York passed Public Health Law § 2505-a, requiring that hospitals support the World Health Organization's (WHO's) recommended "Ten Steps for Successful Breastfeeding" (Ten Steps). This legislation strengthened and codified existing New York State's hospital perinatal regulations. The purpose of this study was to assess hospital policy compliance with New York laws and regulations related to breastfeeding. In 2009, 2011, and 2013, we collected written breastfeeding policies from 129 New York hospitals that provided maternity services. A policy review tool was developed to quantify compliance with the 28 components of breastfeeding support specified in New York Codes, Rules, and Regulations and the new legislation. In 2010 and 2012, hospitals received individual feedback from the New York State Department of Health, which informed hospitals in 2012 that formal regulatory enforcement, including potential fines, would be implemented for noncompliance. The number of components included in hospital policies increased from a mean of 10.4 in 2009, to 16.8 in 2011, and to 27.1 in 2013) (P < .001); a greater increase occurred from 2011 through 2013 than from 2009 through 2011 (P < .001). The percentage of hospitals with fully compliant policies increased from 0% in 2009, to 5% in 2011, and to 75% in 2013 (P < .001), and the percentage that included all WHO's 10 steps increased from 0% to 9% to 87%, respectively (P < .001). Although legislation or regulations requiring certain practices are important, monitoring with enforcement accelerates, and may be necessary for, full implementation. Future research is needed to evaluate the impact of improved hospital breastfeeding policies on breastfeeding outcomes in New York.

  16. Outreach: the western New York Hospital Library Services Program, 1985-1989.

    PubMed Central

    Birkinbine, L A; Bertuca, C A

    1991-01-01

    The Hospital Library Services Program (HLSP) in western New York, during the period covered by its first five-year plan, 1984-1989, is recounted and described. This ongoing program is funded annually by a New York State grant and hospital participation fees. It is designed to support access to biomedical information for health care professionals through a grant program for hospitals with staffed libraries and a circuit program for hospitals without library staffing or without libraries. Hospitals participating in the grant program contribute funds and receive grants for collection development. Hospitals participating in the circuit program pay a participation fee and receive regularly scheduled, documented, circuit librarian visits; a collection development grant; and a grant for contract library services. The program contracts with the State University of New York at Buffalo's (UB) Health Sciences Library to provide computerized literature searches; interlibrary loan (ILL) of journal articles, books, and audiovisuals; and ILL referrals. PMID:1958912

  17. Implementing Legislation to Improve Hospital Support of Breastfeeding, New York State, 2009–2013

    PubMed Central

    Hawke, Bethany A.; Ruberto, Rachael A.; Gregg, Deborah J.

    2015-01-01

    Introduction Increasing breastfeeding is a public health priority supported by strong evidence. In 2009, New York passed Public Health Law § 2505–a, requiring that hospitals support the World Health Organization’s (WHO’s) recommended “Ten Steps for Successful Breastfeeding” (Ten Steps). This legislation strengthened and codified existing New York State’s hospital perinatal regulations. The purpose of this study was to assess hospital policy compliance with New York laws and regulations related to breastfeeding. Methods In 2009, 2011, and 2013, we collected written breastfeeding policies from 129 New York hospitals that provided maternity services. A policy review tool was developed to quantify compliance with the 28 components of breastfeeding support specified in New York Codes, Rules, and Regulations and the new legislation. In 2010 and 2012, hospitals received individual feedback from the New York State Department of Health, which informed hospitals in 2012 that formal regulatory enforcement, including potential fines, would be implemented for noncompliance. Results The number of components included in hospital policies increased from a mean of 10.4 in 2009, to 16.8 in 2011, and to 27.1 in 2013) (P < .001); a greater increase occurred from 2011 through 2013 than from 2009 through 2011 (P < .001). The percentage of hospitals with fully compliant policies increased from 0% in 2009, to 5% in 2011, and to 75% in 2013 (P < .001), and the percentage that included all WHO’s 10 steps increased from 0% to 9% to 87%, respectively (P < .001). Conclusion Although legislation or regulations requiring certain practices are important, monitoring with enforcement accelerates, and may be necessary for, full implementation. Future research is needed to evaluate the impact of improved hospital breastfeeding policies on breastfeeding outcomes in New York. PMID:26226069

  18. Hospital emergency surge capacity: an empiric New York statewide study.

    PubMed

    Kanter, Robert K; Moran, John R

    2007-09-01

    National policy for emergency preparedness calls for hospitals to accommodate surges of 500 new patients per million population in a disaster, but published studies have not evaluated the ability of existing resources to meet these goals. We describe typical statewide and regional hospital occupancy and patterns of variation in occupancy and estimate the ability of hospitals to accommodate new inpatients. Daily hospital occupancy for each hospital was calculated according to admission date and length of stay for each patient during the study period. Occupancy was expressed as the count of occupied beds. Peak hospital capacity was defined as the 95th percentile highest occupancy at each facility. Data obtained from the New York Statewide Planning and Research Cooperative System were analyzed for 1996 to 2002. Patients were classified as children (0 to 14 years, excluding newborns) or adults. Vacant hospital beds per million age-specific population were determined as the difference between peak capacity and average occupancy. In New York State, 242 hospitals cared for a peak capacity of 2,707 children and 46,613 adults. Occupancy averaged 60% of the peak for children and 82% for adults, allowing an average statewide capacity for a surge of 268 new pediatric and 555 adult patients for each million age-specific population. After the September 11, 2001, attacks, in the New York City region, a discretionary modification of admissions and discharges resulted in an 11% reduction from the expected occupancy for children and adults. Typically, there are not enough vacant hospital beds available to serve 500 children per million population. Modified standards of hospital care to expand capacity may be necessary to serve children in a mass-casualty event.

  19. Pre-employment Drug Testing of Housestaff Physicians at a Large Urban Hospital.

    ERIC Educational Resources Information Center

    Lewy, Robert M.

    1991-01-01

    The Columbia-Presbyterian Medical Center (New York City) program of preemployment urine toxicology examinations for beginning housestaff physicians has resulted in treatment for two physicians testing positive for illegal drugs. The program's primary purpose is to focus on substance abuse issues in graduate medical education. (Author/MSE)

  20. Grade pending: lessons for hospital quality reporting from the New York City restaurant sanitation inspection program.

    PubMed

    Ryan, Andrew M; Detsky, Allan S

    2015-02-01

    Public quality reporting programs have been widely implemented in hospitals in an effort to improve quality and safety. One such program is Hospital Compare, Medicare's national quality reporting program for US hospitals. The New York City sanitary grade inspection program is a parallel effort for restaurants. The aims of Hospital Compare and the New York City sanitary inspection program are fundamentally similar: to address a common market failure resulting from consumers' lack of information on quality and safety. However, by displaying easily understandable information at the point of service, the New York City sanitary inspection program is better designed to encourage informed consumer decision making. We argue that this program holds important lessons for public quality reporting of US hospitals. © 2014 Society of Hospital Medicine.

  1. The Epidemiology of Hospitalized Postpartum Depression in New York State, 1995–2004

    PubMed Central

    Savitz, David A.; Stein, Cheryl R.; Ye, Fen; Kellerman, Lisa; Silverman, Michael

    2011-01-01

    Purpose The purpose of this study is to describe the patterns of hospitalization for depression in the year following delivery in relation to social, demographic, and behavioral characteristics. Methods Data on fetal deliveries were linked to hospitalizations for depression over the subsequent year in order to describe the frequency and patterns of hospitalized postpartum depression among 2,355,886 deliveries in New York State from 1995 – 2004. We identified “definite postpartum depression” based on ICD codes indicative of “mental disorders specific to pregnancy,” and “possible postpartum depression” by ICD codes for hospitalization with any depressive disorders. Results In New York State, we identified 1,363 women (5.8 per 10,000) who were hospitalized with definite postpartum depression, and 6,041 women (25.6 per 10,000) with possible postpartum depression, with lower risks in the New York City area. Postpartum depression was more common in later years and among mothers who were older, Black, smokers, lacking private insurance, and with multiple gestations, and was rarer among Asians. For possible postpartum depression, socioeconomic gradients were enhanced. Conclusions Risk of hospitalized postpartum depression is strongly associated with socioeconomic deprivation and varies markedly by ethnicity, with direct implications for screening and health services, also providing suggestions for etiologic studies. PMID:21549277

  2. Black/white differences in very low birth weight neonatal mortality rates among New York City hospitals.

    PubMed

    Howell, Elizabeth A; Hebert, Paul; Chatterjee, Samprit; Kleinman, Lawrence C; Chassin, Mark R

    2008-03-01

    We sought to determine whether differences in the hospitals at which black and white infants are born contribute to black/white disparities in very low birth weight neonatal mortality rates in New York City. We performed a population-based cohort study using New York City vital statistics records on all live births and deaths of infants weighing 500 to 1499 g who were born in 45 hospitals between January 1, 1996, and December 31, 2001 (N = 11 781). We measured very low birth weight risk-adjusted neonatal mortality rates for each New York City hospital and assessed differences in the distributions of non-Hispanic black and non-Hispanic white very low birth weight births among these hospitals. Risk-adjusted neonatal mortality rates for very low birth weight infants in New York City hospitals ranged from 9.6 to 27.2 deaths per 1000 births. White very low birth weight infants were more likely to be born in the lowest mortality tertile of hospitals (49%), compared with black very low birth weight infants (29%). We estimated that, if black women delivered in the same hospitals as white women, then black very low birth weight mortality rates would be reduced by 6.7 deaths per 1000 very low birth weight births, removing 34.5% of the black/white disparity in very low birth weight neonatal mortality rates in New York City. Volume of very low birth weight deliveries was modestly associated with very low birth weight mortality rates but explained little of the racial disparity. Black very low birth weight infants more likely to be born in New York City hospitals with higher risk-adjusted neonatal mortality rates than were very low birth weight infants, contributing substantially to black-white disparities.

  3. Hospitalization Rates Among People With HIV/AIDS in New York City, 2013.

    PubMed

    Lazar, Rachael; Kersanske, Laura; Xia, Qiang; Daskalakis, Demetre; Braunstein, Sarah L

    2017-08-01

    Hospitalizations are an important indicator of healthcare quality and access for people with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). This study assesses hospitalization rates among people with HIV/AIDS in New York City. We performed a deterministic match between people in the New York City HIV surveillance registry alive as of 1 January 2013 and diagnosed with HIV as of 31 December 2013 and patient-level inpatient hospitalization records during 2013. Event-level data were analyzed to determine characteristics of and reasons for hospitalizations. Primary diagnoses were classified using the International Classification of Diseases, Ninth Revision, Clinical Modification. We estimated hospitalization rates as the number of hospitalizations per 100 person-years for all causes, AIDS-defining illnesses, and non-AIDS-defining infections. Nearly one-fifth of hospitalizations were attributed to non-AIDS-defining infections, whereas AIDS-defining illness diagnoses were infrequent (3.6% of hospitalizations). Other common causes were cardiovascular (10.9%) and substance use (9.8%). The estimated all-cause hospitalization rate was 36.7 per 100 person-years. Higher all-cause hospitalization rates were observed among females (46.8 per 100 person-years), Black and Latino/Hispanic people (41.8 and 39.5 per 100 person-years, respectively), people living in high-poverty neighborhoods (47.4 per 100 person-years), and people with a history of injection drug use (74.9 per 100 person-years). The estimated AIDS-defining illness and non-AIDS-defining infection hospitalization rates were 1.3 and 7.2 per 100 person-years, respectively. People with HIV in New York City were frequently hospitalized. While AIDS-defining illnesses were relatively rare, non-AIDS-defining infection hospitalizations were more common. Disparities in hospitalization rates indicate a need for targeted improved primary care and comorbid disease management. © The Author 2017

  4. Use of hospital-based ambulatory care in New York City's Health Manpower Shortage Areas.

    PubMed Central

    Stager, D F; Krasner, M I; Goodwin, E J

    1987-01-01

    The development of a comprehensive data base for hospital-based ambulatory care has made possible the accurate determination of each community's use of hospitals in New York City and permits a reliable estimation of all ambulatory care received by residents of Health Manpower Shortage Areas (HMSAs). In spite of the city's abundant supply of private practitioners and widespread Medicaid coverage, residents of HMSAs in New York City are heavily dependent on hospital-based ambulatory care. Contrary to commonly held notions, however, HMSA residents do not appear to overuse hospital-based ambulatory care. Rather, that use appears to be quite modest, given their poorer health status. PMID:3101118

  5. Impacts of Hospital Budget Limits in Rochester, New York

    PubMed Central

    Friedman, Bernard; Wong, Herbert S.

    1995-01-01

    During 1980-87, eight hospitals in the Rochester, New York area participated in an experimental program to limit total revenue. This article analyzes: increase of costs for Rochester hospitals; trends for inputs and compensation; and cash flow margins. Real expense per case grew annually by about 3 percent less in Rochester. However, after 1984, Medicare prospective payment had an effect of similar size outside Rochester. Some capital inputs to hospital care were restrained, as were wages and particularly benefits. The program did not generally raise or stabilize hospital revenue margins, while the ratio of cash flow to debt trended down. Financial stringency of this program relative to alternatives may have contributed to its end. PMID:10151889

  6. Impacts of hospital budget limits in Rochester, New York.

    PubMed

    Friedman, B; Wong, H S

    1995-01-01

    During 1980-87, eight hospitals in the Rochester, New York area participated in an experimental program to limit total revenue. This article analyzes: increase of costs for Rochester hospitals; trends for inputs and compensation; and cash flow margins. Real expense per case grew annually by about 3 percent less in Rochester. However, after 1984, Medicare prospective payment had an effect of similar size outside Rochester. Some capital inputs to hospital care were restrained, as were wages and particularly benefits. The program did not generally raise or stabilize hospital revenue margins, while the ratio of cash flow to debt trended down. Financial stringency of this program relative to alternatives may have contributed to its end.

  7. Trends in hospitalization for community-associated methicillin-resistant Staphylococcus aureus in New York City, 1997-2006: data from New York State's Statewide Planning and Research Cooperative System.

    PubMed

    Farr, Amanda M; Aden, Brandon; Weiss, Don; Nash, Denis; Marx, Melissa A

    2012-07-01

    To describe trends in hospitalizations with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in New York City over 10 years and to explore the demographics and comorbidities of patients hospitalized with CA-MRSA infections. Retrospective analysis of hospital discharges from New York State's Statewide Planning and Research Cooperative System database from 1997 to 2006. All patients greater than 1 year of age admitted to New York hospitals with diagnosis codes indicating MRSA who met the criteria for CA-MRSA on the basis of admission information and comorbidities. We determined hospitalization rates and compared demographics and comorbidities of patients hospitalized with CA-MRSA versus those hospitalized with all other non-MRSA diagnoses by multivariable logistic regression. Of 18,226 hospitalizations with an MRSA diagnosis over 10 years, 3,579 (20%) were classified as community-associated. The CA-MRSA hospitalization rate increased from 1.47 to 10.65 per 100,000 people overall from 1997 to 2006. Relative to non-MRSA hospitalizations, men, children, Bronx and Manhattan residents, the homeless, patients with human immunodeficiency virus (HIV) infection, and persons with diabetes had higher adjusted odds of CA-MRSA hospitalization. The CA-MRSA hospitalization rate appeared to increase between 1997 and 2006 in New York City, with residents of the Bronx and Manhattan, men, and persons with HIV infection or diabetes at increased odds of hospitalization with CA-MRSA. Further studies are needed to explore how changes in MRSA incidence, access to care, and other factors may have impacted these rates.

  8. How Post-Traumatic Stress Affects Mothers' Perceptions of Their Babies: A Brief Video Feedback Intervention Makes a Difference

    ERIC Educational Resources Information Center

    Schechter, Daniel S.

    2004-01-01

    This article summarizes the scant existing research on the effects of post-traumatic stress disorder (PTSD) on mothers and their babies during the peripartum period and describes a pilot research project within the Infant-Family Service (IFS) at the New York-Presbyterian Hospital, an outpatient mental health service for inner-city families with…

  9. UNITED PRESBYTERIAN NATIONAL EDUCATIONAL SURVEY, AN INTERDISCIPLINARY RESEARCH PROJECT. VOLUME I, THE RESEARCH MODEL.

    ERIC Educational Resources Information Center

    WHITMAN, LAURIS B.; AND OTHERS

    AS PART OF AN OVERALL EVALUATION OF ITS EDUCATIONAL CURRICULUM, THE UNITED PRESBYTERIAN CHURCH, IN 1964, COMMISSIONED THE DEPARTMENT OF RESEARCH OF THE NATIONAL COUNCIL OF CHURCHES TO PROVIDE SYSTEMATIC AND COHERENT PROFILES OF COMMUNICANTS, YOUTH, CHURCH SCHOOL TEACHERS, AND MINISTERS. THIS RESEARCH WAS BASED ON THE INTERDISCIPLINARY APPROACH TO…

  10. An integrated outsourcing solution at York Central Hospital.

    PubMed

    Marr, Jo-Anne; Tam, Richard; Simms, Stephen; Bacchus, Feria

    2011-01-01

    Canadian hospitals struggle to balance the need to increase and improve operational services and quality with diminishing resources. Many realize that sustaining their organization depends on how well they focus their resources and talents on their core business, clinical care delivery. Outsourcing of non-core, non-clinical support services is a solution for many organizations. Most often, this is put into action one service provider at a time. In 2007, however, York Central Hospital (YCH) implemented Sodexo's integrated Comprehensive Service Solutions (CSS) for all its support service functions. In doing so, YCH achieved significant improvements in patient and staff satisfaction rates, substantial cost savings through improved operational efficiency from process improvements and leveraging technology investments, and increased retail food revenue.

  11. Does Negative Interaction in the Church Increase Psychological Distress? Longitudinal Findings from the Presbyterian Panel Survey*

    PubMed Central

    Ellison, Christopher G.; Zhang, Wei; Krause, Neal; Marcum, John P.

    2009-01-01

    This study examines the effects of negative interaction in church on psychological distress. After outlining a series of theoretical arguments linking negative interaction with health and well-being, relevant hypotheses are tested using longitudinal data from two surveys of the 1997–1999 Presbyterian Panel, a nationwide panel of members and elders (lay leaders) in congregations of the Presbyterian Church (USA). Findings confirm that negative interaction appears to foster or exacerbate distress over the study period. In addition, specific dimensions of social negativity have distinctive effects; the impact of criticisms on distress surface only in cross-sectional models, while the effects of excessive demands emerge only in the longitudinal models. No subgroup variations in these effects are detected. Implications of these findings are discussed with regard to (a) research on religion and health and (b) congregational life, and a number of promising directions for future research are elaborated. PMID:20694051

  12. Has price competition changed hospital revenues and expenses in New York?

    PubMed

    Zwanziger, Jack; Mooney, Cathleen

    2005-01-01

    This study analyzes the factors that influenced hospital expenses and revenues prior to and following the enactment of the New York State Health Care Reform Act of 1996 (HCRA)-the period from 1994-1999. HCRA was expected to encourage price competition which in turn was anticipated to lower hospital revenues and expenses. We measured the differential effects on hospital revenues and expenses in markets with varying degrees of competition. We also measured the relationship between hospital revenues and expenses and the increased concentration resulting from the formation of local hospital systems. We found that revenues and expenses both grew more slowly for hospitals located in more competitive markets; hospital systems that increased concentration tended to have higher revenues. In the short run at least, price competition induced by HCRA did constrain both hospital expense and revenue growth, although the increase in hospital mergers countered this trend.

  13. Strategy, leadership and change: the North York General Hospital transformation journey.

    PubMed

    Adamson, Bonnie; Kwolek, Susan

    2008-01-01

    Improvements in the emergency department and general internal medicine will serve as a case study to examine how North York General Hospital cultural transformation efforts led to improvements in these departments, and why we believe this approach will enable the organization to sustain these improvements over time.

  14. 'It's happening at Rush' wins top PRSA award. Integrated marketing effort boosts Rush-Presbyterian-St. Luke's.

    PubMed

    Rees, Tom

    2002-01-01

    An award-winning integrated marketing campaign for Rush-Presbyterian-St. Luke's Medical Center, Chicago, showcases the institution's research and developments. Each edition of its 50-part series of print ads features a different case study. These are being promoted through internal communications and also with highly visible collateral materials.

  15. Telemedicine and its transformation of emergency care: a case study of one of the largest US integrated healthcare delivery systems.

    PubMed

    Sharma, Rahul; Fleischut, Peter; Barchi, Daniel

    2017-12-01

    Innovative methods for delivering healthcare via the use of technology are rapidly growing. Despite the passage of the Affordable Care Act, emergency department visits have continued to rise nationally. Healthcare systems must devise solutions to face these increasing volumes and also deliver high quality care. In response to the changing healthcare landscape, New York Presbyterian Hospital has implemented a comprehensive enterprise wide digital health portfolio which includes the first mobile stroke treatment unit on the east coast and the first emergency department-based digital emergency care program in New York City.

  16. Effect of cause-of-death training on agreement between hospital discharge diagnoses and cause of death reported, inpatient hospital deaths, New York City, 2008-2010.

    PubMed

    Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio; Madsen, Ann

    2015-01-15

    Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions should employ similar interventions to

  17. State University of New York Stony Brook University Hospital: Selected Expenditure Controls. Report 92-S-66.

    ERIC Educational Resources Information Center

    New York State Office of the Comptroller, Albany. Div. of Management Audit.

    An audit was done of selected expenditure controls at the State University of New York (SUNY) at Stony Brook University Hospital particularly payroll costs and procurement practices. The Hospital reported an operating loss of $24 million in 1992. The audit reviewed Hospital management and staff and applicable policies and procedures as well as…

  18. Estimating the Hospital Delivery Costs Associated With Severe Maternal Morbidity in New York City, 2008-2012.

    PubMed

    Howland, Renata E; Angley, Meghan; Won, Sang Hee; Wilcox, Wendy; Searing, Hannah; Tsao, Tsu-Yu

    2018-02-01

    To quantify the average and total hospital delivery costs associated with severe maternal morbidity in excess of nonsevere maternal morbidity deliveries over a 5-year period in New York City adjusting for other sociodemographic and clinical factors. We conducted a population-based cross-sectional study using linked birth certificates and hospital discharge data for New York City deliveries from 2008 to 2012. Severe maternal morbidity was defined using a published algorithm of International Classification of Diseases, 9 Revision, Clinical Modification disease and procedure codes. Hospital costs were estimated by converting hospital charges using factors specific to each year and hospital and to each diagnosis. These estimates approximate what it costs the hospital to provide services (excluding professional fees) and were used in all subsequent analyses. To estimate adjusted mean costs associated with severe maternal morbidity, we used multivariable regression models with a log link, gamma distribution, robust standard errors, and hospital fixed effects, controlling for age, race and ethnicity, neighborhood poverty, primary payer, number of deliveries, method of delivery, comorbidities, and year. We used the adjusted mean cost to determine the average and total hospital delivery costs associated with severe maternal morbidity in excess of nonsevere maternal morbidity deliveries from 2008 to 2012. Approximately 2.3% (n=13,502) of all New York City delivery hospitalizations were complicated by severe maternal morbidity. Compared with nonsevere maternal morbidity deliveries, these hospitalizations were clinically complicated, required more and intensive clinical services, and had a longer stay in the hospital. The average cost of delivery with severe maternal morbidity was $14,442 (95% CI $14,128-14,756), compared with $7,289 (95% CI $7,276-7,302) among deliveries without severe maternal morbidity. After adjusting for other factors, the difference between deliveries

  19. Prevalence of malignant hyperthermia diagnosis in hospital discharge records in California, Florida, New York, and Wisconsin.

    PubMed

    Lu, Zhen; Rosenberg, Henry; Li, Guohua

    2017-06-01

    Malignant hyperthermia (MH) is a rare yet potentially fatal pharmacogenetic disorder triggered by exposure to inhalational anesthetics and the depolarizing neuromuscular blocking agent succinylcholine. Epidemiologic data on the geographic variation in MH prevalence is scant. The objective of this study is to examine the prevalence of recorded MH diagnosis in patients discharged from hospitals in four states in the United States. Observational study. Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) for California (2011), Florida (2011), New York (2012) and Wisconsin (2012). A total of 164 hospital discharges that had a recorded diagnosis of MH using the International Classification of Disease, 9th Revision, Clinical Modification code 995.86. MH prevalence was assessed by patient demographic and clinical characteristics. The prevalence of MH per 100,000 hospital discharges ranged from 1.23 (95% Confidence Interval [CI], 0.80-1.66) in New York to 1.91 (95% CI, 1.48-2.34) in California, and the prevalence of MH per 100,000 surgical discharges ranged from 1.47 (95% CI, 0.93-2.02) in New York to 2.86 (95% CI, 2.00-3.71) in Florida. The prevalence of MH in male patients was more than twice the prevalence in female patients. Of the 164 patients with MH diagnosis, 11% were dead on discharge. There exists a modest variation in the prevalence of recorded MH diagnosis in hospital discharges in California, Florida, New York and Wisconsin. Epidemiologic patterns of MH diagnosis in hospital discharges appear to be similar across the four states. Further research is needed to better understand the geographic variation and contributing factors of MH in different populations. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Cross-mapping clinical notes between hospitals: an application of the LOINC Document Ontology.

    PubMed

    Li, Li; Morrey, C Paul; Baorto, David

    2011-01-01

    Standardization of document titles is essential for management as the volume of electronic clinical notes increases. The two campuses of the New York Presbyterian Hospital have over 2,700 distinct document titles. The LOINC Document Ontology (DO) provides a standard for the naming of clinical documents in a multi-axis structure. We have represented the latest LOINC DO structure in the MED, and developed an automated process mapping the clinical documents from both the West (Columbia) and East (Cornell) campuses to the LOINC DO. We find that the LOINC DO can represent the majority of our documents, and about half of the documents map between campuses using the LOINC DO as a reference. We evaluated the possibility of using current LOINC codes in document exchange between different institutions. While there is clear success in the ability of the LOINC DO to represent documents and facilitate exchange we find there are granularity issues.

  1. Effect of Cause-of-Death Training on Agreement Between Hospital Discharge Diagnoses and Cause of Death Reported, Inpatient Hospital Deaths, New York City, 2008–2010

    PubMed Central

    Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio

    2015-01-01

    Introduction Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. Methods We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Results Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Conclusion Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions

  2. An Intervention to Increase Availability of Healthy Foods and Beverages in New York City Hospitals: The Healthy Hospital Food Initiative, 2010-2014.

    PubMed

    Moran, Alyssa; Krepp, Erica M; Johnson Curtis, Christine; Lederer, Ashley

    2016-06-09

    Hospitals serve millions of meals and snacks each year; however, hospital food is often unhealthy. Hospitals are ideal settings for modeling healthy eating, but few programs have sought to improve nutrition in all venues where food is served. The New York City Department of Health and Mental Hygiene created the Healthy Hospital Food Initiative (HHFI) to improve the healthfulness of food served in hospitals. The HHFI built on prior work implementing mandatory nutrition standards for patient meals and vending in public hospitals. Public hospitals joined the HHFI by voluntarily adopting standards for cafeterias and cafés. Private hospitals joined by implementing nutrition standards for patient meals, food and beverage vending machines, and cafeterias and cafés. Hospitals were recruited from 2010 through 2014 and provided technical assistance from health department staff. Implementation in each of the 4 areas was monitored through on-site assessments and menu review. Twenty-eight hospital cafeterias and cafés were evaluated at baseline and at the end of the HHFI to assess changes. Sixteen public hospitals and 24 private hospitals joined the HHFI. Most (n = 18) private hospitals implemented standards in at least 2 areas. In cafeterias, most hospitals introduced a healthy value meal (n = 19), removed unhealthy items from the entrance and checkout (n = 18), increased whole grains to at least half of all grains served (n = 17), and reduced calories in pastries and desserts (n = 15). Most New York City hospitals joined the HHFI and voluntarily adopted rigorous nutrition standards. Partnerships between hospitals and local government are feasible and can lead to significant improvements in hospital food environments.

  3. Respiratory hospitalizations in association with fine PM and its components in New York State.

    PubMed

    Jones, Rena R; Hogrefe, Christian; Fitzgerald, Edward F; Hwang, Syni-An; Özkaynak, Halûk; Garcia, Valerie C; Lin, Shao

    2015-05-01

    Despite observed geographic and temporal variation in particulate matter (PM)-related health morbidities, only a small number of epidemiologic studies have evaluated the relation between PM2.5 chemical constituents and respiratory disease. Most assessments are limited by inadequate spatial and temporal resolution of ambient PM measurements and/or by their approaches to examine the role of specific PM components on health outcomes. In a case-crossover analysis using daily average ambient PM2.5 total mass and species estimates derived from the Community Multiscale Air Quality (CMAQ) model and available observations, we examined the association between the chemical components of PM (including elemental and organic carbon, sulfate, nitrate, ammonium, and other remaining) and respiratory hospitalizations in New York State. We evaluated relationships between levels (low, medium, high) of PM constituent mass fractions, and assessed modification of the PM2.5-hospitalization association via models stratified by mass fractions of both primary and secondary PM components. In our results, average daily PM2.5 concentrations in New York State were generally lower than the 24-hr average National Ambient Air Quality Standard (NAAQS). Year-round analyses showed statistically significant positive associations between respiratory hospitalizations and PM2.5 total mass, sulfate, nitrate, and ammonium concentrations at multiple exposure lags (0.5-2.0% per interquartile range [IQR] increase). Primarily in the summer months, the greatest associations with respiratory hospitalizations were observed per IQR increase in the secondary species sulfate and ammonium concentrations at lags of 1-4 days (1.0-2.0%). Although there were subtle differences in associations observed between mass fraction tertiles, there was no strong evidence to support modification of the PM2.5-respiratory disease association by a particular constituent. We conclude that ambient concentrations of PM2.5 and secondary

  4. Out of the frying pan: New York City hospitals in an age of deregulation.

    PubMed

    Salit, Sharon; Fass, Steven; Nowak, Mark

    2002-01-01

    For several decades New York City hospitals had been distinguished by their tightly regulated environment, chronically weak finances, high occupancy rates, teaching intensity, dependency on public payers, low managed care penetration, and minimal merger activity. Then in the late 1990s a rapid convergence of forces--the Balanced Budget Act, managed care growth, state deregulation of commercial rates, escalating costs, and plunging hospital occupancy rates--threw the city's hospital industry into turmoil. In this paper we describe this period of turbulent change that has left most of the city's safety-net and small community hospitals near bankruptcy.

  5. An Intervention to Increase Availability of Healthy Foods and Beverages in New York City Hospitals: The Healthy Hospital Food Initiative, 2010–2014

    PubMed Central

    Krepp, Erica M.; Johnson Curtis, Christine; Lederer, Ashley

    2016-01-01

    Background Hospitals serve millions of meals and snacks each year; however, hospital food is often unhealthy. Hospitals are ideal settings for modeling healthy eating, but few programs have sought to improve nutrition in all venues where food is served. Community Context The New York City Department of Health and Mental Hygiene created the Healthy Hospital Food Initiative (HHFI) to improve the healthfulness of food served in hospitals. The HHFI built on prior work implementing mandatory nutrition standards for patient meals and vending in public hospitals. Public hospitals joined the HHFI by voluntarily adopting standards for cafeterias and cafés. Private hospitals joined by implementing nutrition standards for patient meals, food and beverage vending machines, and cafeterias and cafés. Methods Hospitals were recruited from 2010 through 2014 and provided technical assistance from health department staff. Implementation in each of the 4 areas was monitored through on-site assessments and menu review. Twenty-eight hospital cafeterias and cafés were evaluated at baseline and at the end of the HHFI to assess changes. Outcome Sixteen public hospitals and 24 private hospitals joined the HHFI. Most (n = 18) private hospitals implemented standards in at least 2 areas. In cafeterias, most hospitals introduced a healthy value meal (n = 19), removed unhealthy items from the entrance and checkout (n = 18), increased whole grains to at least half of all grains served (n = 17), and reduced calories in pastries and desserts (n = 15). Interpretation Most New York City hospitals joined the HHFI and voluntarily adopted rigorous nutrition standards. Partnerships between hospitals and local government are feasible and can lead to significant improvements in hospital food environments. PMID:27281392

  6. Prevention of hospital-onset Clostridium difficile infection in the New York metropolitan region using a collaborative intervention model.

    PubMed

    Koll, Brian S; Ruiz, Rafael E; Calfee, David P; Jalon, Hillary S; Stricof, Rachel L; Adams, Audrey; Smith, Barbara A; Shin, Gina; Gase, Kathleen; Woods, Maria K; Sirtalan, Ismail

    2014-01-01

    The incidence, severity, and associated costs of Clostridium difficile (C. difficile) infection (CDI) have dramatically increased in hospitals over the past decade, indicating an urgent need for strategies to prevent transmission of C. difficile. This article describes a multifaceted collaborative approach to reduce hospital-onset CDI rates in 35 acute care hospitals in the New York metropolitan region. Hospitals participated in a comprehensive CDI reduction intervention and formed interdisciplinary teams to coordinate their efforts. Standardized clinical infection prevention and environmental cleaning protocols were implemented and monitored using checklists. Monthly data reports were provided to hospitals for facility-specific performance evaluation and comparison to aggregate data from all participants. Hospitals also participated in monthly teleconferences to review data and highlight successes, challenges, and strategies to reduce CDI. Incidence of hospital-onset CDI per 10,000 patient days was the primary outcome measure. Additionally, the incidence of nonhospital-associated, community-onset, hospital-associated, and recurrent CDIs were measured. The use of a collaborative model to implement a multifaceted infection prevention strategy was temporally associated with a significant reduction in hospital-onset CDI rates in participating New York metropolitan regional hospitals. © 2013 National Association for Healthcare Quality.

  7. THE IMPACT OF MEASURES OF SOCIOECONOMIC STATUS ON HOSPITAL PROFILING IN NEW YORK CITY

    PubMed Central

    Blum, Alexander B.; Egorova, Natalia N.; Sosunov, Eugene A.; Gelijns, Annetine C.; DuPree, Erin; Moskowitz, Alan J.; Federman, Alex D.; Ascheim, Deborah D.; Keyhani, Salomeh

    2014-01-01

    Background Current 30-day readmission models used by the Center for Medicare and Medicaid Services for the purpose of hospital-level comparisons lack measures of socioeconomic status (SES). We examined whether the inclusion of a SES measure in 30-day congestive heart failure (CHF) readmission models changed hospital risk standardized readmission rates (RSRR) in New York City (NYC) hospitals. Methods and Results Using a Centers for Medicare & Medicaid Services (CMS)-like model we estimated 30-day hospital-level RSRR by adjusting for age, gender and comorbid conditions. Next, we examined how hospital RSRRs changed relative to the New York City mean with inclusion of the Agency for Healthcare Research and Quality (AHRQ) validated SES index score. In a secondary analysis, we examined whether inclusion of the AHRQ SES Index score in 30-day readmission models disproportionately impacted the RSRR of minority-serving hospitals. Higher AHRQ SES scores, indicators of higher socioeconomic status, were associated with lower odds, 0.99, of 30-day readmission (p< 0.019). The addition of the AHRQ SES index did not change the model’s C statistic (0.63). After adjustment for the AHRQ SES index, one hospital changed status from “worse than the NYC average” to “no different than the NYC average”. After adjustment for the AHRQ SES index, one NYC minority-serving hospital was re-classified from “worse” to “no different than average”. Conclusions While patients with higher SES were less likely to be admitted, the impact of SES on readmission was very small. In NYC, inclusion of the AHRQ SES score in a CMS based model did not impact hospital-level profiling based on 30-day readmission. PMID:24823956

  8. An initial assessment of the cost and utilization of the Integrated Academic Information System (IAIMS) at Columbia Presbyterian Medical Center.

    PubMed Central

    Clayton, P. D.; Anderson, R. K.; Hill, C.; McCormack, M.

    1991-01-01

    The concept of "one stop information shopping" is becoming a reality at Columbia Presbyterian Medical Center (CPMC). The goal of our effort is to provide access to university and hospital administrative systems as well as clinical and library applications from a single workstation, which also provides utility functions such as word processing and mail. Since June 1987, CPMC has invested the equivalent of $23 million dollars to install a digital communications network that encompasses 18 buildings at seven geographically separate sites and to develop clinical and library applications that are integrated with the existing hospital and university administrative and research computing facilities. During June 1991, 2425 different individuals used the clinical information system, 425 different individuals used the library applications, and 900 different individuals used the hospital administrative applications via network access. If we were to freeze the system in its current state, amortize the development and network installation costs, and add projected maintenance costs for the clinical and library applications, our integrated information system would cost $2.8 million on an annual basis. This cost is 0.3% of the medical center's annual budget. These expenditures could be justified by very small improvements in time savings for personnel and/or decreased length of hospital stay and/or more efficient use of resources. In addition to the direct benefits which we detail, a major benefit is the ease with which additional computer-based applications can be added incrementally at an extremely modest cost. PMID:1666966

  9. Symptomatic Gallstones in the Young: Changing Trends of the Gallstone Disease-Related Hospitalization in the State of New York: 1996 - 2010

    PubMed Central

    Chilimuri, Sridhar; Gaduputi, Vinaya; Tariq, Hassan; Nayudu, Suresh; Vakde, Trupti; Glandt, Mariela; Patel, Harish

    2017-01-01

    Background The aim of the study was to evaluate if the gallstone-related hospitalizations in the young (< 20 years of age) have increased over time in both the Bronx County and New York State as a whole. Methods We retrospectively reviewed 15 years (1996 - 2010) of Statewide Planning and Research Cooperative System (SPARCS) data of New York State Department of Health. Patients with ICD-9 code diagnosis of 574 (cholelithiasis) among the first three discharge diagnoses were reviewed. Results Total number of all cause admissions to hospitals had increased from 2.44 million to 2.77 million (1996 - 2010). However, gallstone-related hospitalizations had decreased from 1.7% to 1.2%. It was noted that there was a 30% increment in the proportion of those below 20 years of age with gallstone disease requiring hospitalization over the same period. This young patient population contributed only 2.04% to all gallstone-related hospitalizations in 1996, whereas it had increased to 2.96% in 2010. This trend was more pronounced in women, Hispanics and in those who were residing in the Bronx County as compared to all other New York counties combined. Conclusion The gallstone-related hospitalizations in the young (< 20 years of age) have increased over time in both the Bronx County and New York State as a whole. This could be due to increasing prevalence of risk factors such as obesity, physical inactivity, diabetes and early pregnancy. PMID:28090227

  10. UNITED PRESBYTERIAN NATIONAL EDUCATION SURVEY, AN INTERDISCIPLINARY RESEARCH PROJECT. VOLUMES IIA AND IIB, COMMUNICATIONS VARIABLES IN THE CHURCH.

    ERIC Educational Resources Information Center

    WHITMAN, LAURIS B.; AND OTHERS

    THE DEPARTMENT OF RESEARCH OF THE NATIONAL COUNCIL OF CHURCHES CONDUCTED A SURVEY FOR THE UNITED PRESBYTERIAN CHURCH OF ITS MEMBERSHIP AND RELIGIOUS BELIEFS. THE AIM WAS TO COMPARE VARIOUS POPULATIONS (CLERGY, COMMUNICANTS, CHURCH SCHOOL TEACHERS, AND YOUTH), CONCERNING THE EXTENT OF THEIR ORTHODOXY. VOLUMES IIA AND IIB OF THE REPORT RELATE TO THE…

  11. The contribution of geography to black/white differences in the use of low neonatal mortality hospitals in New York City.

    PubMed

    Hebert, Paul L; Chassin, Mark R; Howell, Elizabeth A

    2011-02-01

    Racial differences in the use of high-quality hospital care contribute to racial disparities in mortality for very low birth weight (VLBW) neonates. We explored the role that geographic distribution of hospitals plays in the racial disparity in the use of top-tier hospitals by mothers of VLBW neonates in New York City. Retrospective analysis of Vital Statistics and administrative databases. VLBW deliveries in New York City from 1996 to 2001 to non-Hispanic Black (n = 4947) and non-Hispanic White (n = 1615) mothers. Black mothers were less likely to deliver in a top-tier hospitals (White = 44%, Black = 28%; P < 0.001) and top-tier hospitals were less likely to be located in Black mothers' neighborhoods (White = 40%, Black = 33%; P < 0.001). Distance, however, did not contribute to the disparity in use of top-tier hospitals. Non-Hispanic Black mothers lived marginally closer to a top-tier hospital than non-Hispanic White mothers (0.65 miles closer; P < 0.001), and mothers of both the races often bypassed their neighborhood hospital (Black = 62% bypassed, White = 71%; P < 0.001). Inattention to recommended prenatal behaviors was associated with using a closer hospital, suggesting that geographic proximity was most important to mothers of vulnerable neonates. Purported measures of hospital quality such as Neonatal Intensive Care Unit level and volume were more strongly associated with use of hospital for White mothers than for Black mothers. The influence of geography on the use of top-tier hospitals for mothers of VLBW neonates is complex. Other personal and hospital characteristics, not just distance or geography, also influenced hospital use in New York City.

  12. Intranet technology in hospital information systems.

    PubMed

    Cimino, J J

    1997-01-01

    The clinical information system architecture at the Columbia-Presbyterian Medical Center in New York is being incorporated into an intranet using Internet and World Wide Web protocols. The result is an Enterprise-Wide Web which provides more flexibility for access to specific patient information and general medical knowledge. Critical aspects of the architecture include a central data repository and a vocabulary server. The new architecture provides ways of displaying patient information in summary, graphical, and multimedia forms. Using customized links called Infobuttons, we provide access to on-line information resources available on the World Wide Web. Our experience to date has raised a number of interesting issues about the use of this technology for health care systems.

  13. The effect of the global financial crisis on preventable hospitalizations among the homeless in New York State.

    PubMed

    White, Brandi; Ellis, Charles; Jones, Walter; Moran, William; Simpson, Kit

    2018-04-01

    Objective Periods of economic instability may increase preventable hospitalizations because of increased barriers to accessing primary care. For underserved populations such as the homeless, these barriers may be more pronounced due to limited resources in the health care safety net. This study examined the impact of the global financial crisis of 2007-2008 on access to care for the homeless in New York State. Methods Hospitalizations for ambulatory care sensitive conditions (ACSCs) were used as a proxy measure for primary care access. Admissions for ACSCs were identified in the New York State Inpatient Database from 2006 to 2012. Hospitalization rates for ACSCs were calculated for the homeless and nonhomeless. Multivariable linear regression was used to investigate the impact of the financial crisis on hospitalization rates for ACSCs. Results The findings indicate that during the financial crisis, homeless adults had significantly higher preventable hospitalizations than nonhomeless adults, and the uninsured homeless had significantly higher preventable hospitalizations when compared to other homeless subgroups. After the financial crisis, preventable hospitalizations for the homeless stabilized but remained at higher rates than those for the nonhomeless. Conclusions These findings are important to developing health policies designed to provide effective care for underserved population such as the homeless.

  14. The Relationship between Ministry Satisfaction and Spiritual Maturity among Adult Church Volunteers in the Korean Presbyterian Church in South Korea

    ERIC Educational Resources Information Center

    Nho, Sung Hyun

    2012-01-01

    This quantitative study examined the relationship between ministry satisfaction and spiritual maturity among adult church volunteers in the Korean Presbyterian church in South Korea (Kosin). It also sought to investigate factors related to volunteers' job satisfaction and their spiritual maturity. Participants included 531 adult small group…

  15. Hospital response to the legalization of abortion in New York State: an analysis of program innovation.

    PubMed

    Miller, J

    1979-12-01

    The reorientation of hospital services in the state of New York to accommodate women's constitutional right to elective abortion was investigated. Market and resource constraints, the social orientations of the organization, and the values of physicians were examined in the effort to evaluate hospital response between 1971 and 1973. Analysis indicates that program innovation in obstetrical and gynecological services to include elective abortion was inhibited by economic factors that generally determined the feasibility of diverting finite resources to a new service and social orientations and values that determined the compatibility of elective abortions with the dominant values underlying hospital operations. The reform of New York abortion statutes and the subsequent ruling by the Supreme Court reiterating the right of women to terminate pregnancy failed to standardize the delivery of health care so that individual rights to service could be obtained everywhere in the state. The social changes ultimately realized through legislative and judicial action were essentially conditional upon the responsiveness of local health care providers. Legal action that failed to specifically address the administrative role of hospitals in social change qualified local access and could not be completely effective in legitimizing the redefinition of abortion in society.

  16. MRSA Causing Infections in Hospitals in Greater Metropolitan New York: Major Shift in the Dominant Clonal Type between 1996 and 2014.

    PubMed

    Pardos de la Gandara, Maria; Curry, Marie; Berger, Judith; Burstein, David; Della-Latta, Phyllis; Kopetz, Virgina; Quale, John; Spitzer, Eric; Tan, Rexie; Urban, Carl; Wang, Guiqing; Whittier, Susan; de Lencastre, Herminia; Tomasz, Alexander

    2016-01-01

    A surveillance study in 1996 identified the USA100 clone (ST5/SCCmecII)-also known as the "New York/Japan" clone-as the most prevalent MRSA causing infections in 12 New York City hospitals. Here we update the epidemiology of MRSA in seven of the same hospitals eighteen years later in 2013/14. Most of the current MRSA isolates (78 of 121) belonged to the MRSA clone USA300 (CC8/SCCmecIV) but the USA100 clone-dominant in the 1996 survey-still remained the second most frequent MRSA (25 of the 121 isolates) causing 32% of blood stream infections. The USA300 clone was most common in skin and soft tissue infections (SSTIs) and was associated with 84.5% of SSTIs compared to 5% caused by the USA100 clone. Our data indicate that by 2013/14, the USA300 clone replaced the New York/Japan clone as the most frequent cause of MRSA infections in hospitals in Metropolitan New York. In parallel with this shift in the clonal type of MRSA, there was also a striking change in the types of MRSA infections from 1996 to 2014.

  17. Association of neighborhood-level factors with hospitalization for community-associated methicillin-resistant Staphylococcus aureus, New York City, 2006: a multilevel observational study.

    PubMed

    Farr, Amanda M; Marx, Melissa A; Weiss, Don; Nash, Denis

    2013-02-13

    Hospitalizations with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection have increased in New York City, with substantial geographic variation across neighborhoods. While individual-level risk factors, such as age, sex, HIV infection, and diabetes have been described, the role of neighborhood-level factors (e.g., neighborhood HIV prevalence or income) has not been examined. To explore plausible neighborhood-level factors associated with CA-MRSA-related hospitalizations, a retrospective analysis was conducted using New York City hospital discharges from 2006 and New York City-specific survey and health department surveillance data. CA-MRSA-related hospitalizations were identified using diagnosis codes and admission information. Associations were determined by using sex-specific multilevel logistic regression. The CA-MRSA hospitalization rate varied by more than six-fold across New York City neighborhoods. Females hospitalized with CA-MRSA had more than twice the odds of residing in neighborhoods in the highest quintile of HIV prevalence (adjusted odds ratio [AOR](Q5 vs. Q1) 2.3, 95% CI: 1.2, 2.7). Both males and females hospitalized with CA-MRSA had nearly twice the odds of residing in neighborhoods with moderately high proportion of men who have sex with men (MSM) residing in the neighborhood (males: AOR(Q4 vs. Q1) 1.7, 95% CI: 1.1, 2.7; females: AOR(Q4 vs. Q1) 2.0, 95% CI: 1.1, 3.6); but this association did not hold for neighborhoods in the highest quintile (males: AOR(Q5 vs. Q1) 1.2, 95% CI: 0.76, 1.8; females: AOR(Q5 vs. Q1) 1.5, 95% CI: 0.82, 2.7). Neighborhood-level characteristics were associated with CA-MRSA hospitalization odds, independent of individual-level risk factors, and may contribute to the population-level burden of CA-MRSA infection.

  18. Clinical Information Systems Integration in New York City's First Mobile Stroke Unit.

    PubMed

    Kummer, Benjamin R; Lerario, Michael P; Navi, Babak B; Ganzman, Adam C; Ribaudo, Daniel; Mir, Saad A; Pishanidar, Sammy; Lekic, Tim; Williams, Olajide; Kamel, Hooman; Marshall, Randolph S; Hripcsak, George; Elkind, Mitchell S V; Fink, Matthew E

    2018-01-01

    Mobile stroke units (MSUs) reduce time to thrombolytic therapy in acute ischemic stroke. These units are widely used, but the clinical information systems underlying MSU operations are understudied. The first MSU on the East Coast of the United States was established at New York Presbyterian Hospital (NYP) in October 2016. We describe our program's 7-month pilot, focusing on the integration of our hospital's clinical information systems into our MSU to support patient care and research efforts. NYP's MSU was staffed by two paramedics, one radiology technologist, and a vascular neurologist. The unit was equipped with four laptop computers and networking infrastructure enabling all staff to access the hospital intranet and clinical applications during operating hours. A telephone-based registration procedure registered patients from the field into our admit/discharge/transfer system, which interfaced with the institutional electronic health record (EHR). We developed and implemented a computerized physician order entry set in our EHR with prefilled values to permit quick ordering of medications, imaging, and laboratory testing. We also developed and implemented a structured clinician note to facilitate care documentation and clinical data extraction. Our MSU began operating on October 3, 2016. As of April 27, 2017, the MSU transported 49 patients, of whom 16 received tissue plasminogen activator (t-PA). Zero technical problems impacting patient care were reported around registration, order entry, or intranet access. Two onboard network failures occurred, resulting in computed tomography scanner malfunctions, although no patients became ineligible for time-sensitive treatment as a result. Thirteen (26.5%) clinical notes contained at least one incomplete time field. The main technical challenges encountered during the integration of our hospital's clinical information systems into our MSU were onboard network failures and incomplete clinical documentation. Future

  19. Use of Nutrition Standards to Improve Nutritional Quality of Hospital Patient Meals: Findings from New York City's Healthy Hospital Food Initiative.

    PubMed

    Moran, Alyssa; Lederer, Ashley; Johnson Curtis, Christine

    2015-11-01

    Most hospital patient meals are considered regular-diet meals; these meals are not required to meet comprehensive nutrition standards for a healthy diet. Although programs exist to improve nutrition in hospital food, the focus is on retail settings such as vending machines and cafeterias vs patient meals. New York City's Healthy Hospital Food Initiative (HHFI) provides nutrition standards for regular-diet meals that hospitals can adopt, in addition to retail standards. This study was undertaken to describe regular-diet patient menus before and after implementation of the HHFI nutrition standards. The study involved pre- and post- menu change analyses of hospitals participating in the HHFI between 2010 and 2014. Eight New York City hospitals, selected based on voluntary participation in the HHFI, were included in the analyses. Nutritional content of regular-diet menus were compared with the HHFI nutrition standards. Nutrient analysis and exact Wilcoxon signed-rank tests were used for the analysis of the data. At baseline, no regular-diet menu met all HHFI standards, and most exceeded the daily limits for percentage of calories from fat (n=5), percentage of calories from saturated fat (n=5), and milligrams of sodium (n=6), and they did not meet the minimum grams of fiber (n=7). Hospitals met all key nutrient standards after implementation, increasing fiber (25%, P<0.01) and decreasing sodium (-19%, P<0.05), percentage of calories from fat (-24%, P<0.01), and percentage of calories from saturated fat (-21%, P<0.05). A significant increase was seen in fresh fruit servings (667%, P<0.05) and decreases in full-fat and reduced-fat milk servings (-100%, P<0.05), refined grain servings (-35%, P<0.05), and frequency of desserts (-92%, P<0.05). Regular diet menus did not comply with the HHFI nutrition standards at baseline. Using the HHFI framework, hospitals significantly improved the nutritional quality of regular-diet patient menus. The standards were applied across

  20. Characteristics and Associated Comorbidities of Pediatric Dental Patients Treated under General Anesthesia.

    PubMed

    Delfiner, Alexandra; Myers, Aaron; Lumsden, Christie; Chussid, Steve; Yoon, Richard

    To describe characteristics and identify common comorbidities of children receiving dental treatment under general anesthesia at Children's Hospital of New York-Presbyterian. Electronic medical records of all children that received dental treatment under general anesthesia through the Division of Pediatric Dentistry from 2012-2014 were reviewed. Data describing patient characteristics (age, sex, race/ethnicity, insurance carrier, and American Society of Anesthesiologists physical status classification system), medical history, and justification for treatment were collected. Descriptive statistics, including frequencies, percentages and t-tests, were calculated. A total of 298 electronic medical records were reviewed, of which 50 records were excluded due to missing information. Of the 248 electronic medical records included, the average age was 5-years-old and 58% were male. The most common reason for dental treatment under general anesthesia was extent and severity of dental disease (53%), followed by significant medical history (47%) and behavior/pre-cooperative age (39%). Those who were ASA III or IV were older (6.6-years) (p<.001). Common medical comorbidities appear evenly distributed: autism (12%), cardiac anomalies (14%), developmental delay (14%), genetic syndromes/chromosomal disorders (13%), and neurological disorders (12%). Younger age groups (1 to 2 years and 3 to 5 years) had a high percentage of hospitalizations due to the extent and severity of the dental disease (83%) and behavior (77%) (p<0.001). No single comorbidity was seen more often than others in this patient population. The range of medical conditions in this population may be a reflection of the range of pediatric specialty services at Children's Hospital of NewYork-Presbyterian.

  1. Implementing Innovation: The Creation of an iUnit and the Role of Nursing.

    PubMed

    Tiase, Victoria L; Ventura, Rosemary; Sorbello, Daniel; Robinson, Kenya

    2016-01-01

    NewYork-Presbyterian Hospital took on the challenge of thinking about innovation differently with the implementation of an innovation unit or iUnit to create the patient care unit of the future. Goals were to understand more about the innovation process and to test new service models, technology platforms, devices, and deployment models. Key findings from the focus groups included the need for additional training and technical support. In general, the initiative was felt to improve overall communication and represents a starting point for further innovation programs.

  2. A case-mix in-service education program.

    PubMed

    Arons, R R

    1985-01-01

    The new case-mix in-service education program at the Presbyterian Hospital in the City of New York is a fine example of physicians and administration working together to achieve success under the new prospective pricing system. The hospital's office of Case-Mix Studies has developed an accurate computer-based information system with historical, clinical, and demographic data for patients discharged from the hospital over the past five years. Reports regarding the cases, diagnoses, finances, and characteristics are shared in meetings with the hospital administration and directors of sixteen clinical departments, their staff, attending physicians, and house officers in training. The informative case-mix reports provide revealing sociodemographic summaries and have proven to be an invaluable tool for planning, marketing, and program evaluation.

  3. Correlation of hospital magnet status with the quality of physicians performing neurosurgical procedures in New York State.

    PubMed

    Bekelis, Kimon; Missios, Symeon; MacKenzie, Todd A

    2018-01-24

    The quality of physicians practicing in hospitals recognized for nursing excellence by the American Nurses Credentialing Center has not been studied before. We investigated whether Magnet hospital recognition is associated with higher quality of physicians performing neurosurgical procedures. We performed a cohort study of patients undergoing neurosurgical procedures from 2009-2013, who were registered in the New York Statewide Planning and Research Cooperative System (SPARCS) database. Propensity score adjusted multivariable regression models were used to adjust for known confounders, with mixed effects methods to control for clustering at the facility level. An instrumental variable analysis was used to control for unmeasured confounding and simulate the effect of a randomized trial. During the study period, 185,277 patients underwent neurosurgical procedures, and met the inclusion criteria. Of these, 66,607 (35.6%) were hospitalized in Magnet hospitals, and 118,670 (64.4%) in non-Magnet institutions. Instrumental variable analysis demonstrated that undergoing neurosurgical operations in Magnet hospitals was associated with a 13.6% higher chance of being treated by a physician with superior performance in terms of mortality (95% CI, 13.2% to 14.1%), and a 4.3% higher chance of being treated by a physician with superior performance in terms of length-of-stay (LOS) (95% CI, 3.8% to 4.7%) in comparison to non-Magnet institutions. The same associations were present in propensity score adjusted mixed effects models. Using a comprehensive all-payer cohort of neurosurgical patients in New York State we identified an association of Magnet hospital recognition with superior physician performance.

  4. Harmful Algal Bloom–Associated Illness Surveillance: Lessons From Reported Hospital Visits in New York, 2008–2014

    PubMed Central

    Muscatiello, Neil; Wilson, Lloyd; Dziewulski, David

    2016-01-01

    We identified hospital visits with reported exposure to harmful algal blooms, an emerging public health concern because of toxicity and increased incidence. We used the World Health Organization’s International Classification of Disease (ICD) medical code specifying environmental exposure to harmful algal blooms to extract hospital visit records in New York State from 2008 to 2014. Using the ICD code, we identified 228 hospital visits with reported exposure to harmful algal blooms. They occurred all year long and had multiple principal diagnoses. Of all hospital visits, 94.7% were managed in the emergency department and 5.3% were hospitalizations. As harmful algal bloom surveillance increases, the ICD code will be a beneficial tool to public health only if used properly. PMID:26794161

  5. Case Outcomes in a Communication-and-Resolution Program in New York Hospitals.

    PubMed

    Mello, Michelle M; Greenberg, Yelena; Senecal, Susan K; Cohn, Janet S

    2016-12-01

    To determine case outcomes in a communication-and-resolution program (CRP) implemented to respond to adverse events in general surgery. Five acute-care hospitals in New York City. Following CRP implementation, hospitals recorded information about each CRP event for 22 months. Risk managers prospectively collected data in collaboration with representatives from the hospital's insurer. External researchers administered an online satisfaction survey to clinicians involved in CRP events. Among 125 CRP cases, disclosure conversations were carried out in 92 percent, explanations were conveyed in 88 percent, and apologies were offered in 72.8 percent. Three quarters of events did not involve substandard care. Compensation offers beyond bill waivers were deemed appropriate in 9 of 30 of cases in which substandard care caused harm and communicated in six such cases. In 44 percent of cases, hospitals identified steps that could be taken to improve safety. Clinicians had low awareness of the workings of the CRP, but high satisfaction with their experiences. The bulk of CRPs' work is in investigating and communicating about events not caused by substandard care. These CRPs were quite successful in handling such events, but less consistent in offering compensation in cases involving substandard care. © Health Research and Educational Trust.

  6. Hospital graduate social work field work programs: a study in New York City.

    PubMed

    Showers, N

    1990-02-01

    Twenty-seven hospital field work programs in New York City were studied. Questionnaires were administered to program coordinators and 238 graduate social work students participating in study programs. High degrees of program structural complexity and variation were found, indicating a state of art well beyond that described in the general field work literature. High rates of student satisfaction with learning, field instructors, programs, and the overall field work experience found suggest that the complexity of study programs may be more effective than traditional field work models. Statistically nonsignificant study findings indicate areas in which hospital social work departments may develop field work programs consistent with shifting organizational needs, without undue risk to educational effectiveness. Statistically significant findings suggest areas in which inflexibility in program design may be more beneficial in the diagnostic related groups era.

  7. The Effect of Severity of Illness on Spine Surgery Costs Across New York State Hospitals: An Analysis of 69,831 Cases.

    PubMed

    Kaye, I David; Adrados, Murillo; Karia, Raj J; Protopsaltis, Themistocles S; Bosco, Joseph A

    2017-11-01

    Observational database review. To determine the effect of patient severity of illness (SOI) on the cost of spine surgery among New York state hospitals. National health care spending has risen at an unsustainable rate with musculoskeletal care, and spine surgery in particular, accounting for a significant portion of this expenditure. In an effort towards cost-containment, health care payers are exploring novel payment models some of which reward cost savings but penalize excessive spending. To mitigate risk to health care institutions, accurate cost forecasting is essential. No studies have evaluated the effect of SOI on costs within spine surgery. The New York State Hospital Inpatient Cost Transparency Database was reviewed to determine the costs of 69,831 hospital discharges between 2009 and 2011 comprising the 3 most commonly performed spine surgeries in the state. These costs were then analyzed in the context of the specific all patient refined diagnosis-related group (DRG) SOI modifier to determine this index's effect on overall costs. Overall, hospital-reported cost increases with the patient's SOI class and patients with worse baseline health incur greater hospital costs (P<0.001). Moreover, these costs are increasingly variable for each worsening SOI class (P<0.001). This trend of increasing costs is persistent for all 3 DRGs across all 3 years studied (2009-2011), within each of the 7 New York state regions, and occurs irrespective of the hospital's teaching status or size. Using the 3M all patient refined-DRG SOI index as a measure of patient's health status, a significant increase in cost for spine surgery for patients with higher SOI index was found. This study confirms the greater cost and variability of spine surgery for sicker patients and illustrates the inherent unpredictability in cost forecasting and budgeting for these same patients.

  8. Variation in Formula Supplementation of Breastfed Newborn Infants in New York Hospitals.

    PubMed

    Nguyen, Trang; Dennison, Barbara A; Fan, Wei; Xu, Changning; Birkhead, Guthrie S

    2017-07-01

    We examined the variation between 126 New York hospitals in formula supplementation among breastfed infants after adjusting for socioeconomic, maternal, and infant factors and stratifying by level of perinatal care. We used 2014 birth certificate data for 160 911 breastfed infants to calculate hospital-specific formula supplementation percentages by using multivariable hierarchical logistic regression models. Formula supplementation percentages varied widely among hospitals, from 2.3% to 98.3%, and was lower among level 1 hospitals (18.2%) than higher-level hospitals (50.6%-57.0%). Significant disparities in supplementation were noted for race and ethnicity (adjusted odds ratios [aORs] were 1.54-2.05 for African Americans, 1.85-2.74 for Asian Americans, and 1.25-2.16 for Hispanics, compared with whites), maternal education (aORs were 2.01-2.95 for ≤12th grade, 1.74-1.85 for high school or general education development, and 1.18-1.28 for some college or a college degree, compared with a Master's degree), and insurance coverage (aOR was 1.27-1.60 for Medicaid insurance versus other). Formula supplementation was higher among mothers who smoked, had a cesarean delivery, or diabetes. At all 4 levels of perinatal care, there were exemplar hospitals that met the HealthyPeople 2020 supplementation goal of ≤14.2%. After adjusting for individual risk factors, the hospital-specific, risk-adjusted supplemental formula percentages still revealed a wide variation. A better understanding of the exemplar hospitals could inform future efforts to improve maternity care practices and breastfeeding support to reduce unnecessary formula supplementation, reduce disparities, increase exclusive breastfeeding and breastfeeding duration, and improve maternal and child health outcomes. Copyright © 2017 by the American Academy of Pediatrics.

  9. Lesson From the New York City Out-of-Hospital Uncontrolled Donation After Circulatory Determination of Death Program.

    PubMed

    Wall, Stephen P; Kaufman, Bradley J; Williams, Nicholas; Norman, Elizabeth M; Gilbert, Alexander J; Munjal, Kevin G; Maikhor, Shana; Goldstein, Michael J; Rivera, Julia E; Lerner, Harvey; Meyers, Chad; Machado, Marion; Montella, Susan; Pressman, Marcy; Teperman, Lewis W; Dubler, Nancy N; Goldfrank, Lewis R

    2016-04-01

    In 2006, the Institute of Medicine emphasized substantial potential to expand organ donation opportunities through uncontrolled donation after circulatory determination of death (uDCDD). We pilot an out-of-hospital uDCDD kidney program for New York City in partnership with communities that it was intended to benefit. We evaluate protocol process and outcomes while identifying barriers to success and means for improvement. We conducted a prospective, participatory action research study in Manhattan from December 2010 to May 2011. Daily from 4 to 12 pm, our organ preservation unit monitored emergency medical services (EMS) frequencies for cardiac arrests occurring in private locations. After EMS providers independently ordered termination of resuscitation, organ preservation unit staff determined clinical eligibility and donor status. Authorized parties, persons authorized to make organ donation decisions, were approached about in vivo preservation. The study population included organ preservation unit staff, authorized parties, passersby, and other New York City agency personnel. Organ preservation unit staff independently documented shift activities with daily operations notes and teleconference summaries that we analyzed with mixed qualitative and quantitative methods. The organ preservation unit entered 9 private locations; all the deceased lacked previous registration, although 4 met clinical screening eligibility. No kidneys were recovered. We collected 837 notes from 35 organ preservation unit staff. Despite frequently recounting protocol breaches, most responses from passersby including New York City agencies were favorable. No authorized parties were offended by preservation requests, yielding a Bayesian posterior median 98% (95% credible interval 76% to 100%). In summary, the New York City out-of-hospital uDCDD program was not feasible. There were frequent protocol breaches and confusion in determining clinical eligibility. In the small sample of

  10. Development of the breastfeeding quality improvement in hospitals learning collaborative in New York state.

    PubMed

    Fitzpatrick, Eileen; Dennison, Barbara A; Welge, Sara Bonam; Hisgen, Stephanie; Boyce, Patricia Simino; Waniewski, Patricia A

    2013-06-01

    Exclusive breastfeeding is a public health priority. A strong body of evidence links maternity care practices, based on the Ten Steps to Successful Breastfeeding, to increased breastfeeding initiation, duration and exclusivity. Despite having written breastfeeding policies, New York (NY) hospitals vary widely in reported maternity care practices and in prevalence rates of breastfeeding, especially exclusive breastfeeding, during the birth hospitalization. To improve hospital maternity care practices, breastfeeding support, and the percentage of infants exclusively breastfeeding, the NY State Department of Health developed the Breastfeeding Quality Improvement in Hospitals (BQIH) Learning Collaborative. The BQIH Learning Collaborative was the first to use the Institute for Health Care Improvement's Breakthrough Series methodology to specifically focus on increasing hospital breastfeeding support. The evidence-based maternity care practices from the Ten Steps to Successful Breastfeeding provided the basis for the Change Package and Data Measurement Plan. The present article describes the development of the BQIH Learning Collaborative. The engagement of breastfeeding experts, partners, and stakeholders in refining the Learning Collaborative design and content, in defining the strategies and interventions (Change Package) that drive hospital systems change, and in developing the Data Measurement Plan to assess progress in meeting the Learning Collaborative goals and hospital aims is illustrated. The BQIH Learning Collaborative is a model program that was implemented in a group of NY hospitals with plans to spread to additional hospitals in NY and across the country.

  11. Does objective quality of physicians correlate with patient satisfaction measured by Hospital Compare metrics in New York State?

    PubMed Central

    Bekelis, Kimon; Missios, Symeon; MacKenzie, Todd A.; O’Shaughnessy, Patrick M.

    2017-01-01

    Background It is unclear whether publicly reported benchmarks correlate with the quality of physicians and institutions. We investigated the association of patient satisfaction measures from a public reporting platform with the performance of neurosurgeons in New York State. Methods We performed a cohort study involving patients undergoing neurosurgical operations from 2009–2013, who were registered in the Statewide Planning and Research Cooperative System (SPARCS) database. This cohort was merged with publicly available data from the CMS Hospital Compare website. A propensity adjusted regression analysis was used to investigate the association of patient satisfaction metrics with neurosurgeon quality, as measured by their individual rate of mortality and average length-of-stay (LOS). Results Overall, 166,365 patients underwent neurosurgical procedures during the study. Using a propensity adjusted multivariable regression analysis we demonstrated that undergoing neurosurgical operations in hospitals with a greater percentage of patient-assigned “high” score were associated with higher chance of being treated by a physician with superior performance in terms of mortality (OR 1.90; 95% CI, 1.86 to 1.95), and a higher chance of being treated by a physician with superior performance in terms of length-of-stay (LOS) (OR 1.24; 95% CI, 1.21 to 1.27). Similar associations were identified for hospitals with a higher percentage of patients, who claimed they would recommend these institutions to others. Conclusions Merging a comprehensive all-payer cohort of neurosurgery patients in New York State with data from the CMS Hospital Compare website, we observed an association of superior hospital-level patient satisfaction measures with the objective performance of individual neurosurgeons in the corresponding hospitals. PMID:28456743

  12. Correlation Between Aeroallergen Levels and New Diagnosis of Eosinophilic Esophagitis in New York City.

    PubMed

    Fahey, Lisa; Robinson, Guy; Weinberger, Kate; Giambrone, Ashley E; Solomon, Aliza B

    2017-01-01

    The relation between food allergies and eosinophilic esophagitis (EoE) is well established. Aeroallergens may also contribute to the development of EoE; however, there are limited data to support or refute this hypothesis. The objectives of this pilot study were to determine whether there is a seasonal variation in the onset of symptoms and/or diagnosis of EoE and whether these variations correlate with a specific pollen concentration within New York City. We performed a retrospective chart review to identify all pediatric patients at New York Presbyterian Weill Cornell Medical Center diagnosed with EoE between 2002 and 2012. Sixty-six patients were identified and 28 were excluded. Cases were classified by both date of initial symptoms and date of histologic diagnosis. Pollen counts from a certified New York City counting station and the percentage of EoE cases were collated monthly and seasonally and compared. There was a seasonal variation in onset of symptoms and diagnosis of EoE, with the highest number of patients reporting onset of symptoms of EoE in July to September, and those being diagnosed with EoE in October to December. There was a seasonal correlation between peak levels of grass pollen and peak onset of EoE symptoms, which were both highest in July to September. The diagnosis of EoE peaked one season later. The study findings suggest that there is a correlation between specific aeroallergens and both the onset of symptoms and time of diagnosis of patients with EoE.

  13. Impact of nursing overtime on nurse-sensitive patient outcomes in New York hospitals, 1995-2000.

    PubMed

    Berney, Barbara; Needleman, Jack

    2006-05-01

    During the past several years, nurses and their advocates have expressed concern about heavy use of overtime in hospitals and claimed that it undermines the quality of nursing care. Using staffing and discharge data covering 1995 to 2000 from 161 acute general hospitals in New York State, this study uses multi variate regression to analyze the relationship between overtime and the rates of six nurse-sensitive patient outcomes and mortality. We find an association of overtime with lower rates of mortality in medical and surgical patients but do not consider these findings definitive. Because overtime use is episodic and unit specific, further study of these issues using data that examines the occurrence of adverse events by unit during periods of heavy nurse overtime is recommended.

  14. Productivity vs. training in primary care: analysis of hospitals and health centers in New York City.

    PubMed

    DeLia, Derek; Cantor, Joel C; Duck, Elaine

    2002-01-01

    This paper examines the indirect costs of primary care residency in terms of ambulatory care site productivity and the influence of graduate medical education (GME) subsidies on the employment of primary care residents. Using a sample of hospitals and health centers in New York City (NYC), we find that most facilities employ significantly more primary care residents relative to nonresident primary care physicians than would be dictated by cost-minimizing behavior in the production of primary care. We also find evidence that New York's GME subsidy encourages the "overemployment" of residents, while the Medicare GME subsidy does not. We conclude that the trade-off between productivity and teaching is more serious in primary care than in inpatient settings, and that facilities heavily involved in ambulatory care teaching will be at a competitive disadvantage if GME subsidies are not targeted specifically for primary care.

  15. Trends in Penile Prosthetics: Influence of Patient Demographics, Surgeon Volume, and Hospital Volume on Type of Penile Prosthesis Inserted in New York State.

    PubMed

    Kashanian, James A; Golan, Ron; Sun, Tianyi; Patel, Neal A; Lipsky, Michael J; Stahl, Peter J; Sedrakyan, Art

    2018-02-01

    Penile prostheses (PPs) are a discrete, well-tolerated treatment option for men with medical refractory erectile dysfunction. Despite the increasing prevalence of erectile dysfunction, multiple series evaluating inpatient data have found a decrease in the frequency of PP surgery during the past decade. To investigate trends in PP surgery and factors affecting the choice of different PPs in New York State. This study used the New York State Department of Health Statewide Planning and Research Cooperative (SPARCS) data cohort that includes longitudinal information on hospital discharges, ambulatory surgery, emergency department visits, and outpatient services. Patients older than 18 years who underwent inflatable or non-inflatable PP insertion from 2000 to 2014 were included in the study. Influence of patient demographics, surgeon volume, and hospital volume on type of PP inserted. Since 2000, 14,114 patients received PP surgery in New York State; 12,352 PPs (88%) were inflatable and 1,762 (12%) were non-inflatable, with facility-level variation from 0% to 100%. There was an increasing trend in the number of annual procedures performed, with rates of non-inflatable PP insertion decreasing annually (P < .01). More procedures were performed in the ambulatory setting over time (P < .01). Important predictors of device choice were insurance type, year of insertion, hospital and surgeon volume, and the presence of comorbidities. Major influences in choice of PP inserted include racial and socioeconomic factors and surgeon and hospital surgical volume. Use of the SPARCS database, which captures inpatient and outpatient services, allows for more accurate insight into trends in contrast to inpatient sampling alone. However, SPARCS is limited to patients within New York State and the results might not be generalizable to men in other states. Also, patient preference was not accounted for in these analyses, which can play a role in PP selection. During the past 14 years, there

  16. Probing the diphosphoglycerate binding pocket of HbA and HbPresbyterian (beta 108Asn --> Lys).

    PubMed

    Gottfried, D S; Manjula, B N; Malavalli, A; Acharya, A S; Friedman, J M

    1999-08-31

    HbPresbyterian (beta 108Asn --> Lys, HbP) contains an additional positive charge (per alpha beta dimer) in the middle of the central cavity and exhibits a lower oxygen affinity than wild-type HbA in the presence of chloride. However, very little is known about the molecular origins of its altered functional properties. In this study, we have focused on the beta beta cleft of the Hb tetramer. Recently, we developed an approach for quantifying the ligand binding affinity to the beta-end of the Hb central cavity using fluorescent analogues of the natural allosteric effector 2, 3-diphosphoglycerate (DPG) [Gottfried, D. S., et al. (1997) J. Biol. Chem. 272, 1571-1578]. Time-correlated single-photon counting fluorescence lifetime studies were used to assess the binding of pyrenetetrasulfonate to both HbA and HbP in the deoxy and CO ligation states under acidic and neutral pH conditions. Both the native and mutant proteins bind the probe at a weak binding site and a strong binding site; in all cases, the binding to HbP was stronger than to HbA. The most striking finding was that for HbA the binding affinity varies as follows: deoxy (pH 6.35) > deoxy (pH 7.20) > CO (pH 6.35); however, the binding to HbP is independent of ligation or pH. The mutant oxy protein also hydrolyzes p-nitrophenyl acetate, through a reversible acyl-imidazole pathway linked to the His residues of the beta beta cleft, at a considerably higher rate than does HbA. This implies a perturbation of the microenvironment of these residues at the DPG binding pocket. Structural consequences due to the presence of the new positive charge in the middle of the central cavity have been transmitted to the beta beta cleft of the protein, even in its liganded conformation. This is consistent with a newly described quaternary state (B) for liganded HbPresbyterian and an associated change in the allosteric control mechanism.

  17. Temporal and Spatial Patterns in Utilization of Mental Health Services During and After Hurricane Sandy: Emergency Department and Inpatient Hospitalizations in New York City.

    PubMed

    He, Fangtao Tony; Lundy De La Cruz, Nneka; Olson, Donald; Lim, Sungwoo; Levanon Seligson, Amber; Hall, Gerod; Jessup, Jillian; Gwynn, Charon

    2016-06-01

    Hurricane Sandy made landfall on October 29, 2012, causing a coastal storm surge and extensive flooding, which led to the closure of several health care facilities in New York City (NYC) and prolonged interruptions in service delivery. The impact on mental health-related emergency department (ED) and inpatient hospital service utilization was studied. Data came from the New York Statewide Planning and Research Cooperative System. We obtained mental health-related data among NYC residents from 2010 to 2013. Patients were grouped into 5 geographic areas, including service areas of closed hospitals, the Hurricane Sandy evaluation zone, and all of NYC. The Farrington method was used to detect increases in ED visits and hospitalizations for the post-Sandy period. Open hospitals experienced a substantial increase in psychiatric ED visits from patients living in the service areas of closed hospitals. This surge in psychiatric ED visits persisted for 4 to 6 months after Hurricane Sandy. However, the increase in psychiatric hospitalizations was observed for 1 to 3 months. Several NYC hospitals received a substantially larger number of ED patients from service areas of closed hospitals after Hurricane Sandy, unlike other hospitals that experienced a decrease. Because of potential surges in the number of psychiatric ED visits, resource allocation to hospitals should be considered. (Disaster Med Public Health Preparedness. 2016;10:512-517).

  18. The New York State risk score for predicting in-hospital/30-day mortality following percutaneous coronary intervention.

    PubMed

    Hannan, Edward L; Farrell, Louise Szypulski; Walford, Gary; Jacobs, Alice K; Berger, Peter B; Holmes, David R; Stamato, Nicholas J; Sharma, Samin; King, Spencer B

    2013-06-01

    This study sought to develop a percutaneous coronary intervention (PCI) risk score for in-hospital/30-day mortality. Risk scores are simplified linear scores that provide clinicians with quick estimates of patients' short-term mortality rates for informed consent and to determine the appropriate intervention. Earlier PCI risk scores were based on in-hospital mortality. However, for PCI, a substantial percentage of patients die within 30 days of the procedure after discharge. New York's Percutaneous Coronary Interventions Reporting System was used to develop an in-hospital/30-day logistic regression model for patients undergoing PCI in 2010, and this model was converted into a simple linear risk score that estimates mortality rates. The score was validated by applying it to 2009 New York PCI data. Subsequent analyses evaluated the ability of the score to predict complications and length of stay. A total of 54,223 patients were used to develop the risk score. There are 11 risk factors that make up the score, with risk factor scores ranging from 1 to 9, and the highest total score is 34. The score was validated based on patients undergoing PCI in the previous year, and accurately predicted mortality for all patients as well as patients who recently suffered a myocardial infarction (MI). The PCI risk score developed here enables clinicians to estimate in-hospital/30-day mortality very quickly and quite accurately. It accurately predicts mortality for patients undergoing PCI in the previous year and for MI patients, and is also moderately related to perioperative complications and length of stay. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  19. Use, trends, and impacts of nurse overtime in New York hospitals, 1995--2000

    NASA Astrophysics Data System (ADS)

    Berney, Barbara L.

    Over the last several years, nurses and their advocates have expressed concern about heavy use of overtime (OT) in hospitals and claimed that it undermines the quality of nursing care. Some hospital managers view OT as an important staffing and scheduling tool. This study examines trends in the use of nurse overtime and its effects on several nurse-sensitive patient outcomes. Previous studies have demonstrated a relationship between several patient outcomes and nurse staffing levels, but little is known about the impact of nurse overtime on patient outcomes. Using staffing and discharge data covering 1995 to 2000 from 160 acute general hospitals in New York State, this study examines hospital characteristics that are associated with the use of OT. These characteristics include size, location, RN unionization, hospital ownership and teaching status. The study examines trends in the use of OT. Finally, it uses multivariate regression to analyze the relationship between OT and the rates of six nurse-sensitive patient outcomes and mortality. Significant differences were observed in the use of OT by hospital ownership and by union status. Government hospitals used less OT than non-government hospitals. Non-union hospitals used slightly less OT than hospitals with unionized nurses. As total RN hours and straight (non-OT) hours per acute inpatient day increased, OT decreased. OT use as a percent of total inpatient RN hours increased significantly over the study period from 3.9% to 5.5%. Trends varied by hospital characteristic. This dissertation finds little evidence for an association between nurse OT and patient outcomes. One reason may be that the administrative data used track OT use and adverse events for whole years. Since OT use is episodic, data that examine the occurrence of adverse events during periods of heavy nurse overtime may be more sensitive to the impact of OT. That hospitals vary dramatically in their OT use and that some categories of hospitals (e

  20. Rate Regulation as a Policy Tool: Lessons From New York State

    PubMed Central

    Fraser, Irene

    1995-01-01

    For over a decade, New York State has used hospital rate regulation (the New York Prospective Hospital Reimbursement Methodology [NYPHRM]) as a policy tool to achieve three objectives: containing costs, supporting financially stressed hospitals, and financing access to care for the uninsured. This case study of NYPHRM suggests that the regulatory approach, if pursued with vigor, can achieve any one of these goals. On the other hand, the New York experience also shows that these are competing goals, and that achieving all of them over a period of time can prove to be difficult. PMID:10142575

  1. An intervention to improve cause-of-death reporting in New York City hospitals, 2009-2010.

    PubMed

    Madsen, Ann; Thihalolipavan, Sayone; Maduro, Gil; Zimmerman, Regina; Koppaka, Ram; Li, Wenhui; Foster, Victoria; Begier, Elizabeth

    2012-01-01

    Poor-quality cause-of-death reporting reduces reliability of mortality statistics used to direct public health efforts. Overreporting of heart disease has been documented in New York City (NYC) and nationwide. Our objective was to evaluate the immediate and longer-term effects of a cause-of-death (COD) educational program that NYC's health department conducted at 8 hospitals on heart disease reporting and on average conditions per certificate, which are indicators of the quality of COD reporting. From June 2009 through January 2010, we intervened at 8 hospitals that overreported heart disease deaths in 2008. We shared hospital-specific data on COD reporting, held conference calls with key hospital staff, and conducted in-service training. For deaths reported from January 2009 through June 2011, we compared the proportion of heart disease deaths and average number of conditions per death certificate before and after the intervention at both intervention and nonintervention hospitals. At intervention hospitals, the proportion of death certificates that reported heart disease as the cause of death decreased from 68.8% preintervention to 32.4% postintervention (P < .001). Individual hospital proportions ranged from 58.9% to 79.5% preintervention and 25.9% to 45.0% postintervention. At intervention hospitals the average number of conditions per death certificate increased from 2.4 conditions preintervention to 3.4 conditions postintervention (P < .001) and remained at 3.4 conditions a year later. At nonintervention hospitals, these measures remained relatively consistent across the intervention and postintervention period. This NYC health department's hospital-level intervention led to durable changes in COD reporting.

  2. Impact of surgeon and hospital experience on outcomes of abdominal aortic aneurysm repair in New York State.

    PubMed

    Meltzer, Andrew J; Connolly, Peter H; Schneider, Darren B; Sedrakyan, Art

    2017-09-01

    This study aimed to assess the impact of the surgeon's and hospital's experience on the outcomes of open surgical repair (OSR) and endovascular aneurysm repair (EVAR) of intact and ruptured abdominal aortic aneurysms (AAAs) in New York State. New York Statewide Planning and Research Cooperative System data were used to identify patients undergoing AAA repair from 2000 to 2011. Characteristics of the provider and hospital were determined by linkage to the New York Office of Professions and National Provider Identification databases. Distinct hierarchical logistic regression models for EVAR and OSR for intact and ruptured AAAs were created to adjust for the patient's comorbidities and to evaluate the impact of the surgeon's and hospital's experience on outcomes. The provider's years since medical school graduation as well as annual volume of the facility and provider are examined in tertiles. Adjusted odds ratios and 95% confidence intervals are presented. A total of 18,842 patients underwent AAA repair by a vascular surgeon. For intact AAAs (n = 17,118), 26.2% of patients underwent OSR and 73.8% underwent EVAR. For ruptured AAAs (n = 1724), 63.9% underwent OSR and 36.1% underwent EVAR. After intact AAA repair, OSR adjusted outcomes were significantly influenced by the surgeon's annual volume but not by the facility's volume or the surgeon's age. The lowest volume providers (1-4 OSRs) had higher in-hospital mortality rates than high-volume (>11 OSRs) surgeons (adjusted odds ratio, 1.87 [95% confidence interval, 1.1-3.17]). Low-volume providers also had higher odds of major complications (1.23 [1-1.51]). For patients with intact AAA undergoing EVAR, mortality was higher at low-volume facilities (2.6 [1.3-5.3] and 2.7 [1.5-4.8] for <33 EVARs and 34-81 EVARs, respectively). After OSR for ruptured AAA, treatment at a low-volume facility (<9 OSRs for ruptured AAA) was associated with greater mortality than at high-volume (>27 OSRs for ruptured AAA) centers (1.56 [1

  3. Health Facilities: New York State's Oversight of Nursing Homes and Hospitals. Report to the Honorable Bill Green, House of Representatives.

    ERIC Educational Resources Information Center

    General Accounting Office, New York, NY. Regional Office.

    At the request of Congressman William Green, the General Accounting Office (GAO) evaluated the validity of allegations about deficiencies in the New York State Department of Health's nursing home and hospital inspection processes for certification for participation in the Medicare and Medicaid programs. Health Care Financing Administration and…

  4. The New York risk score for in-hospital and 30-day mortality for coronary artery bypass graft surgery.

    PubMed

    Hannan, Edward L; Farrell, Louise Szypulski; Wechsler, Andrew; Jordan, Desmond; Lahey, Stephen J; Culliford, Alfred T; Gold, Jeffrey P; Higgins, Robert S D; Smith, Craig R

    2013-01-01

    Simplified risk scores for coronary artery bypass graft surgery are frequently in lieu of more complicated statistical models and are valuable for informed consent and choice of intervention. Previous risk scores have been based on in-hospital mortality, but a substantial number of patients die within 30 days of the procedure. These deaths should also be accounted for, so we have developed a risk score based on in-hospital and 30-day mortality. New York's Cardiac Surgery Reporting System was used to develop an in-hospital and 30-day logistic regression model for patients undergoing coronary artery bypass graft surgery in 2009, and this model was converted into a simple linear risk score that provides estimated in-hospital and 30-day mortality rates for different values of the score. The accuracy of the risk score in predicting mortality was tested. This score was also validated by applying it to 2008 New York coronary artery bypass graft data. Subsequent analyses evaluated the ability of the risk score to predict complications and length of stay. The overall in-hospital and 30-day mortality rate for the 10,148 patients in the study was 1.79%. There are seven risk factors comprising the score, with risk factor scores ranging from 1 to 5, and the highest possible total score is 23. The score accurately predicted mortality in 2009 as well as in 2008, and was strongly correlated with complications and length of stay. The risk score is a simple way of estimating short-term mortality that accurately predicts mortality in the year the model was developed as well as in the previous year. Perioperative complications and length of stay are also well predicted by the risk score. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Altruistic unbalanced paired kidney exchange at Columbia University/New York-Presbyterian hospital: rationale and practical considerations.

    PubMed

    Ratner, Lloyd E; Ratner, Emily R; Kelly, Joan; Carrol, Maureen; Cherwinski, Karyn; Ernst, Victoria; Rana, Abbas

    2008-01-01

    Paired kidney exchanges are being used with increasing frequency to overcome humoral immunologic incompatibilities between patients in need of renal transplantation and their potential live donors. Altruistic unbalanced exchanges utilize compatible donor/recipient pairs in order to facilitate the transplantation of a patient with an incompatible donor. We have now performed several altruistic unbalanced paired kidney exchanges at our institution. Also, we have surveyed potential donors and recipients regarding their attitudes toward participating in altruistic unbalanced paired kidney exchanges. Patients are most amenable to participation if they perceive a benefit from trading away a compatible donor. Given the number of compatible live donor transplants performed annually, if practiced on a broad scale, altruistic unbalancedpaired kidney exchanges can have a profound impact upon the supply of kidneys for transplantation. These exchanges can be performed at individual centers without the requirement for largesharing pools or complex computer algorithms. However, there are a number of ethical and logistical considerations that must be addressed. Altruistic unbalanced paired kidney exchanges represent a major paradigm shift in renal transplantation, in that a private resource (i.e. the live kidney donor) is converted to a shared or public one.

  6. Preventable Hospitalization Rates and Neighborhood Poverty among New York City Residents, 2008-2013.

    PubMed

    Bocour, Angelica; Tria, Maryellen

    2016-12-01

    Knowing which demographic groups have higher rates of preventable hospitalizations can help identify geographic areas where improvements in primary care access and quality can be made. This study assessed whether preventable hospitalization rates by neighborhood poverty decreased from 2008 to 2013 and whether the gap between very high and low poverty neighborhoods changed. We examined trends in age-adjusted preventable hospitalization rates and rate ratios by neighborhood poverty overall and by sex using JoinPoint regression. Prevention Quality Indicators (PQIs) developed by the Agency for Healthcare Research and Quality were applied to inpatient hospitalization data from the New York State Department of Health's Statewide Planning and Research Cooperative System. PQIs were classified into composites. From 2008 to 2013, preventable hospitalization rates per 100,000 adults across each poverty group decreased. For very high poverty neighborhoods (ZIP codes with ≥30 % of persons living below the federal poverty level (FPL)), there were significant decreases overall (3430.56 to 2543.10, annual percent change [APC] = -5.91 %), for diabetes (676.15 to 500.83, APC = -5.75 %), respiratory (830.78 to 660.29, APC = -4.85 %), circulatory (995.69 to 701.81, APC = -7.24 %), and acute composites (928.18 to 680.17, APC = -5.62 %). The rate ratios also decreased over time; however, in 2013, the rates for very high poverty neighborhoods were two to four times higher than low poverty neighborhoods (ZIP codes with <10 % of persons below the FPL). While preventable hospitalization rates have decreased over time, disparities still exist. These findings underscore the need to ensure adequate access to quality and timely primary care among individuals living in high poverty neighborhoods.

  7. Changes in hospitality workers' exposure to secondhand smoke following the implementation of New York's smoke-free law

    PubMed Central

    Farrelly, M; Nonnemaker, J; Chou, R; Hyland, A; Peterson, K; Bauer, U

    2005-01-01

    Objective: To assess the impact on hospitality workers' exposure to secondhand smoke of New York's smoke-free law that prohibits smoking in all places of employment, including restaurants, bars, and bowling facilities. Design: Pre-post longitudinal follow up design. Settings: Restaurants, bars, and bowling facilities in New York State. Subjects: At baseline, 104 non-smoking workers in restaurants, bars, and bowling facilities were recruited with newspaper ads, flyers, and radio announcements. Of these, 68 completed a telephone survey and provided at least one saliva cotinine specimen at baseline. At three, six, and 12 month follow up studies, 47, 38, and 32 workers from the baseline sample of 68 completed a telephone survey and provided at least one saliva cotinine specimen. Intervention: The smoke-free law went into effect 24 July 2003. Main outcome measures: Self reported sensory and respiratory symptoms and exposure to secondhand smoke; self administered saliva cotinine specimens. Analyses were limited to subjects in all four study periods who completed a telephone survey and provided at least one saliva cotinine specimen. Results: All analyses were limited to participants who completed both an interview and a saliva specimen for all waves of data collection (n = 30) and who had cotinine concentrations ⩽ 15 ng/ml (n = 24). Hours of exposure to secondhand smoke in hospitality jobs decreased from 12.1 hours (95% confidence interval (CI) 8.0 to 16.3 hours) to 0.2 hours (95% CI –0.1 to 0.5 hours) (p < 0.01) and saliva cotinine concentration decreased from 3.6 ng/ml (95% CI 2.6 to 4.7 ng/ml) to 0.8 ng/ml (95% CI 0.4 to 1.2 ng/ml) (p < 0.01) from baseline to the 12 month follow up. The prevalence of workers reporting sensory symptoms declined from 88% (95% CI 66% to 96%) to 38% (95% CI 20% to 59%) (p < 0.01); there was no change in the overall prevalence of upper respiratory symptoms (p < 0.16). Conclusion: New York's smoke-free law had its intended effect of

  8. Changes in hospitality workers' exposure to secondhand smoke following the implementation of New York's smoke-free law.

    PubMed

    Farrelly, M C; Nonnemaker, J M; Chou, R; Hyland, A; Peterson, K K; Bauer, U E

    2005-08-01

    To assess the impact on hospitality workers' exposure to secondhand smoke of New York's smoke-free law that prohibits smoking in all places of employment, including restaurants, bars, and bowling facilities. Pre-post longitudinal follow up design. Restaurants, bars, and bowling facilities in New York State. At baseline, 104 non-smoking workers in restaurants, bars, and bowling facilities were recruited with newspaper ads, flyers, and radio announcements. Of these, 68 completed a telephone survey and provided at least one saliva cotinine specimen at baseline. At three, six, and 12 month follow up studies, 47, 38, and 32 workers from the baseline sample of 68 completed a telephone survey and provided at least one saliva cotinine specimen. The smoke-free law went into effect 24 July 2003. Self reported sensory and respiratory symptoms and exposure to secondhand smoke; self administered saliva cotinine specimens. Analyses were limited to subjects in all four study periods who completed a telephone survey and provided at least one saliva cotinine specimen. All analyses were limited to participants who completed both an interview and a saliva specimen for all waves of data collection (n = 30) and who had cotinine concentrations < or = 15 ng/ml (n = 24). Hours of exposure to secondhand smoke in hospitality jobs decreased from 12.1 hours (95% confidence interval (CI) 8.0 to 16.3 hours) to 0.2 hours (95% CI -0.1 to 0.5 hours) (p < 0.01) and saliva cotinine concentration decreased from 3.6 ng/ml (95% CI 2.6 to 4.7 ng/ml) to 0.8 ng/ml (95% CI 0.4 to 1.2 ng/ml) (p < 0.01) from baseline to the 12 month follow up. The prevalence of workers reporting sensory symptoms declined from 88% (95% CI 66% to 96%) to 38% (95% CI 20% to 59%) (p < 0.01); there was no change in the overall prevalence of upper respiratory symptoms (p < 0.16). New York's smoke-free law had its intended effect of protecting hospitality workers from exposure to secondhand smoke within three months of

  9. Are Facebook user ratings associated with hospital cost, quality and patient satisfaction? A cross-sectional analysis of hospitals in New York State.

    PubMed

    Campbell, Lauren; Li, Yue

    2018-02-01

    Hospital care costs are high while quality varies across hospitals. Patient satisfaction may be associated with better clinical quality, and social media ratings may offer another opportunity to measure patient satisfaction with care. To test if Facebook user ratings of hospitals are associated with existing measures of patient satisfaction, cost and quality. Data were obtained from Centers for Medicare and Medicaid Services Hospital Compare, the Hospital Inpatient Prospective Payment System impact files and the Area Health Resource File for 2015. Information from hospitals' Facebook pages was collected in July 2016. Multivariate linear regression was used to test if there is an association between Facebook user ratings (star rating and adjusted number of 'likes') and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction measures, the 30-day all-cause readmission rate, and the Medicare spending per beneficiary (MSPB) ratio. One hundred and thirty-six acute care hospitals in New York State in 2015. An increase in the Facebook star rating is associated with significant increases in 21/23 HCAHPS measures (p≤0.003). An increase in the adjusted number of 'likes' is associated with very small increases in 3/23 HCAHPS measures (p<0.05). Facebook user ratings are not associated with the 30-day all-cause readmission rate or the Medicare spending per beneficiary ratio. Results demonstrate an association between HCAHPS patient satisfaction measures and Facebook star ratings. Adjusted number of 'likes' may not be a useful measure of patient satisfaction. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. The Centralization of Total Joint Arthroplasty in New York State An Analysis of 168,247 Cases.

    PubMed

    Adrados, Murillo; Theobald, Jason; Hutzler, Lorraine; Bosco, Joseph

    2016-11-01

    We identified 168,247 total hip and total knee arthroplasties performed in New York State between 2010 and 2012 to examine the evidence for increased geographical and institutional centralization of these procedures. We measured the increased growth of high volume institutions as compared to lower volume hospitals in New York State. We found a high proportion of total arthroplasties already performed in the dozen biggest hospitals in New York back in 2010 and a significant higher growth of these high volume, "centers of excellence," hospitals when compared to low volume hospitals.

  11. Gaining control: reform, reimbursement and politics in New York's community hospitals, 1890--1915.

    PubMed Central

    Rosner, D

    1980-01-01

    This is an historical study of an early twentieth century political struggle regarding hospital reimbursement in New York City. During a period called the "Progressive Era" (1895--1915), administrators in the City's Comptroller's office sought to gain control over small, locally run community hospitals by dismantling the long-standing practice of flat-grant payments to institutions. Central office planners felt that these payments gave too much control to trustees. In its place, the Comptroller initiated a system of per-capita, per-diem reimbursement. Inspectors now judged for the institutions which services and which clients were appropriate for municipal reimbursement. From the perspective of the Comptroller's office, this change was an attempt to put rationality into the system of municipal support for charitable institutions. From the perspective of trustees and community representatives, however, this change was a political attack on the rights of institutions and local communities to control their own fate. Within the context of the larger Progressive Era "good government" movement to centralize decision-making in the hands of experts who believed strongly in the efficiency of larger institutions, it was generally the smallest, most financially troubled community institutions which felt the brunt of these changes. PMID:6990801

  12. Indoor air quality in hospitality venues before and after implementation of a clean indoor air law--Western New York, 2003.

    PubMed

    2004-11-12

    Secondhand smoke (SHS) contains more than 50 carcinogens. SHS exposure is responsible for an estimated 3,000 lung cancer deaths and more than 35,000 coronary heart disease deaths among never smokers in the United States each year, and for lower respiratory infections, asthma, sudden infant death syndrome, and chronic ear infections among children. Even short-term exposures to SHS, such as those that might be experienced by a patron in a restaurant or bar that allows smoking, can increase the risk of experiencing an acute cardiovascular event. Although population-based data indicate declining SHS exposure in the United States over time, SHS exposure remains a common but preventable public health hazard. Policies requiring smoke-free environments are the most effective method of reducing SHS exposure. Effective July 24, 2003, New York implemented a comprehensive state law requiring almost all indoor workplaces and public places (e.g., restaurants, bars, and other hospitality venues) to be smoke-free. This report describes an assessment of changes in indoor air quality that occurred in 20 hospitality venues in western New York where smoking or indirect SHS exposure from an adjoining room was observed at baseline. The findings indicate that, on average, levels of respirable suspended particles (RSPs), an accepted marker for SHS levels, decreased 84% in these venues after the law took effect. Comprehensive clean indoor air policies can rapidly and effectively reduce SHS exposure in hospitality venues.

  13. Designated Stroke Center Status and Hospital Characteristics as Predictors of In-Hospital Mortality among Hemorrhagic Stroke Patients in New York, 2008-2012.

    PubMed

    Gatollari, Hajere J; Colello, Anna; Eisenberg, Bonnie; Brissette, Ian; Luna, Jorge; Elkind, Mitchell S V; Willey, Joshua Z

    2017-01-01

    Although designated stroke centers (DSCs) improve the quality of care and clinical outcomes for ischemic stroke patients, less is known about the benefits of DSCs for patients with intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). Compared to non-DSCs, hospitals with the DSC status have lower in-hospital mortality rates for hemorrhagic stroke patients. We believed these effects would sustain over a period of time after adjusting for hospital-level characteristics, including hospital size, urban location, and teaching status. We evaluated ICH (International Classification of Diseases, Ninth Revision; ICD-9: 431) and SAH (ICD-9: 430) hospitalizations documented in the 2008-2012 New York State Department of Health Statewide Planning and Research Cooperative System inpatient sample database. Generalized estimating equation logistic regression was used to evaluate the association between DSC status and in-hospital mortality. We calculated ORs and 95% CIs adjusted for clustering of patients within facilities, other hospital characteristics, and individual level characteristics. Planned secondary analyses explored other hospital characteristics associated with in-hospital mortality. In 6,352 ICH and 3,369 SAH patients in the study sample, in-hospital mortality was higher among those with ICH compared to SAH (23.7 vs. 18.5%). Unadjusted analyses revealed that DSC status was related with reduced mortality for both ICH (OR 0.7, 95% CI 0.5-0.8) and SAH patients (OR 0.4, 95% CI 0.3-0.7). DSC remained a significant predictor of lower in-hospital mortality for SAH patients (OR 0.6, 95% CI 0.3-0.9) but not for ICH patients (OR 0.8, 95% CI 0.6-1.0) after adjusting for patient demographic characteristics, comorbidities, hospital size, teaching status and location. Admission to a DSC was independently associated with reduced in-hospital mortality for SAH patients but not for those with ICH. Other patient and hospital characteristics may explain the benefits of DSC

  14. 25. 'VIEW OF CITY HOSPITAL DISTRICT, BLACKWELL'S ISLAND, FROM MANHATTAN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    25. 'VIEW OF CITY HOSPITAL DISTRICT, BLACKWELL'S ISLAND, FROM MANHATTAN SHORE.' (Source: New York City Department of Public Finance, Real Estate Owned by the City of New York Under Jurisdiction of the Department of Public Charities, 1909.) - Island Hospital, Roosevelt Island, New York County, NY

  15. Attachment to God, Images of God, and Psychological Distress in a Nationwide Sample of Presbyterians.

    PubMed

    Bradshaw, Matt; Ellison, Christopher G; Marcum, Jack P

    2010-01-01

    Drawing broadly on insights from attachment theory, the present study outlines a series of theoretical arguments linking styles of attachment to God, perceptions of the nature of God (i.e., God imagery), and stressful life events with psychological distress. Main effects and potential stress-moderator effects are then evaluated using data from a nationwide sample of elders and rank-and-file members of the Presbyterian Church (U.S.A.). Key findings indicate that secure attachment to God is inversely associated with distress, whereas both anxious attachment to God and stressful life events are positively related to distress. Once variations in patterns of attachment to God are controlled, there are no net effects of God imagery on levels of distress. There is only modest support for the hypothesis that God images moderate the effects of stressful life events on psychological distress, but no stress-moderator effects were found for attachment to God. Study limitations are identified, and findings are discussed in terms of their implications for religion-health research, as well as recent extensions of attachment theory.

  16. Attachment to God, Images of God, and Psychological Distress in a Nationwide Sample of Presbyterians

    PubMed Central

    Bradshaw, Matt; Ellison, Christopher G.; Marcum, Jack P.

    2012-01-01

    Drawing broadly on insights from attachment theory, the present study outlines a series of theoretical arguments linking styles of attachment to God, perceptions of the nature of God (i.e., God imagery), and stressful life events with psychological distress. Main effects and potential stress-moderator effects are then evaluated using data from a nationwide sample of elders and rank-and-file members of the Presbyterian Church (U.S.A.). Key findings indicate that secure attachment to God is inversely associated with distress, whereas both anxious attachment to God and stressful life events are positively related to distress. Once variations in patterns of attachment to God are controlled, there are no net effects of God imagery on levels of distress. There is only modest support for the hypothesis that God images moderate the effects of stressful life events on psychological distress, but no stress-moderator effects were found for attachment to God. Study limitations are identified, and findings are discussed in terms of their implications for religion-health research, as well as recent extensions of attachment theory. PMID:23329878

  17. Health-hazard evaluation report HETA 87-063-1808, Presbyterian Day Surgery Center, Albuquerque, New Mexico

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Daniels, W.J.; Gunter, B.

    1987-07-01

    In response to a request from employees to evaluate exposures to waste anesthetic gases and vapors at the Presbyterian Day Surgery Unit, located in Albuquerque, New Mexico, personal and area air-sampling and leak-detection testing was carried out for nitrous oxide (N/sub 2/O) and halogenated anesthetic agents in the six operating rooms at the facility. Nitrous oxide concentrations ranged from not detectable to 95 parts per million (ppm) with a mean of 20ppm. Five of the samples exceeded the NIOSH limit of 25ppm for N/sub 2/O during anesthetic administration. Ethrane levels in 14 personal and area air samples ranged from lessmore » than the limit of detection to 3.63ppm with a mean of 0.31ppm. Isoflurane and halothane were below the limits of detection. The ventilation system in use changed the air in excess of 20 times per hour. However, during a portion of surgical procedures the system was not operating, resulting in a higher than normal exposure level in three of the operating rooms.« less

  18. Hospital-Based Emergency Department Visits With Dental Conditions: Impact of the Medicaid Reimbursement Fee for Dental Services in New York State, 2009-2013.

    PubMed

    Rampa, Sankeerth; Wilson, Fernando A; Wang, Hongmei; Wehbi, Nizar K; Smith, Lynette; Allareddy, Veerasathpurush

    2018-06-01

    Hospital-based emergency department (ED) visits for dental problems have been on the rise. The objectives of this study are to provide estimates of hospital-based ED visits with dental conditions in New York State and to examine the impact of Medicaid reimbursement fee for dental services on the utilization of EDs with dental conditions. New York State Emergency Department Database for the year 2009-2013 and Health Resources and Services Administration's Area Health Resource File were used. All ED visits with diagnosis for dental conditions were selected for analysis. The present study found a total of 325,354 ED visits with dental conditions. The mean age of patient was 32.4 years. A majority of ED visits were made by those aged 25-44 years (49%). Whites comprised 52.1% of ED visits. Proportion of Medicaid increased from 22% (in 2009) to 41.3% (in 2013). For Medicaid patients, the mean ED charges and aggregated ED charges were $811.4 and $88.1 million, respectively. Eleven counties had fewer than 4 dentists per 10,000 population in New York State. High-risk groups identified from the study are those aged 25-44 years, uninsured, covered by Medicaid and private insurance, and residing in low-income areas. The study highlights the need for increased Medicaid reimbursement for dentists and improves access to preventive dental care especially for the vulnerable groups. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. The Regionalization of Lumbar Spine Procedures in New York State: A 10-Year Analysis.

    PubMed

    Jancuska, Jeffrey; Adrados, Murillo; Hutzler, Lorraine; Bosco, Joseph

    2016-01-01

    A retrospective review of an administrative database. The purpose of this study is to determine the current extent of regionalization by mapping lumbar spine procedures according to hospital and patient zip code, as well as examine the rate of growth of lumbar spine procedures performed at high-, medium-, and low-volume institutions in New York State. The association between hospital and spine surgeon volume and improved patient outcomes is well established. There is no study investigating the actual process of patient migration to high-volume hospitals. New York Statewide Planning and Research Cooperative System (SPARCS) administrative data were used to identify 228,695 lumbar spine surgery patients from 2005 to 2014. The data included the patients' zip code, hospital of operation, and year of discharge. The volume of lumbar spine surgery in New York State was mapped according to patient and hospital 3-digit zip code. New York State hospitals were categorized as low, medium, and high volume and descriptive statistics were used to determine trends in changes in hospital volume. Lumbar spine surgery recipients are widely distributed throughout the state. Procedures are regionalized on a select few metropolitan centers. The total number of procedures grew 2.5% over the entire 10-year-period. High-volume hospital caseload increased 50%, from 7253 procedures in 2005 to 10,915 procedures in 2014. The number of procedures at medium and low-volume hospitals decreased 30% and 13%, respectively. Despite any concerted effort aimed at moving orthopedic patients to high-volume hospitals, migration to high-volume centers occurred. Public interest in quality outcomes and cost, as well as financial incentives among medical centers to increase market share, potentially influence the migration of patients to high-volume centers. Further regionalization has the potential to exacerbate the current level of disparities among patient populations at low and high-volume hospitals. 3.

  20. Prevalence and Clinical Attributes of Congenital Microcephaly - New York, 2013-2015.

    PubMed

    Graham, Krishika A; Fox, Deborah J; Talati, Achala; Pantea, Cristian; Brady, Laura; Carter, Sondra L; Friedenberg, Eric; Vora, Neil M; Browne, Marilyn L; Lee, Christopher T

    2017-02-10

    Congenital Zika virus infection can cause microcephaly and other severe fetal neurological anomalies (1). To inform microcephaly surveillance efforts and assess ascertainment sources, the New York State Department of Health and the New York City Department of Health and Mental Hygiene sought to determine the prevalence of microcephaly in New York during 2013-2015, before known importation of Zika virus infections. Suspected newborn microcephaly diagnoses were identified from 1) reports submitted by birth hospitals in response to a request and 2) queries of a hospital administrative discharge database for newborn microcephaly diagnoses. Anthropometric measurements, maternal demographics, and pregnancy characteristics were abstracted from newborn records from both sources. Diagnoses were classified using microcephaly case definitions developed by CDC and the National Birth Defects Prevention Network (NBDPN) (2). During 2013-2015, 284 newborns in New York met the case definition for severe congenital microcephaly (prevalence = 4.2 per 10,000 live births). Most newborns with severe congenital microcephaly were identified by both sources; 263 (93%) were identified through hospital requests and 256 (90%) were identified through administrative discharge data. The proportions of newborns with severe congenital microcephaly who were black (30%) or Hispanic (31%) were higher than the observed proportions of black (15%) or Hispanic (23%) infants among New York live births. Fifty-eight percent of newborns with severe congenital microcephaly were born to mothers with pregnancy complications or who had in utero or perinatal infections or teratogenic exposures, genetic disorders, or family histories of birth defects.

  1. On the history of New York Medical College.

    PubMed

    Greenberg, S J

    1986-01-01

    The history of New York Medical College reflects three distinct trends in the development of medical education: the rise and fall of homeopathy, the input of civic leaders (in this case, William Cullen Bryant) and the uneasy relationship between medical schools and hospitals caused by the dramatic increase in the complexity and cost of hospital care.

  2. Maternal mortality in New York--Looking back, looking forward.

    PubMed

    Chazotte, Cynthia; D'Alton, Mary E

    2016-03-01

    New York City was ahead of its time in recognizing the issue of maternal death and the need for proper statistics. New York has also documented since the 1950s the enormous public health challenge of racial disparities in maternal mortality. This paper addresses the history of the first Safe Motherhood Initiative (SMI), a voluntary program in New York State to review reported cases of maternal deaths in hospitals. Review teams found that timely recognition and intervention in patients with serious morbidity could have prevented many of the deaths reviewed. Unfortunately the program was defunded by New York State. The paper then focuses on the revitalization of the SMI in 2013 to establish three safety bundles across the state to be used in the recognition and treatment of obstetric hemorrhage, severe hypertension in pregnancy, and the prevention of venous thromboembolism; and their introduction into 118 hospitals across the state. The paper concludes with a look to the future of the coordinated efforts needed by various organizations involved in women's healthcare in New York City and State to achieve the goal of a review of all maternal deaths in the state by a multidisciplinary team in a timely manner so that appropriate feedback to the clinical team can be given and care can be modified and improved as needed. It is the authors' opinion that we owe this type of review to the women of New York who entrust their care to us. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Has competition lowered hospital prices?

    PubMed

    Zwanziger, Jack; Mooney, Cathleen

    2005-01-01

    On Jan. 1, 1997, New York ended its regulation of hospital prices with the intent of using competitive markets to control prices and increase efficiency. This paper uses data that come from annual reports filed by all health maintenance organizations (HMOs) operating in New York and include payments to and usage in the major hospitals in an HMO's network. We estimate the relationship between implied prices and hospital, plan, and market characteristics. The models show that after 1997, hospitals in more competitive markets paid less. Partially offsetting these price reductions were price increases associated with hospital mergers that reduced the competitiveness of the local market. Hospital deregulation was successful, at least in the short run, in using price competition to reduce hospital payments; it is unclear whether this success will be undermined by the structural changes taking place in the hospital industry.

  4. Massive blood transfusion during hospitalization for delivery in New York State, 1998-2007.

    PubMed

    Mhyre, Jill M; Shilkrut, Alexander; Kuklina, Elena V; Callaghan, William M; Creanga, Andreea A; Kaminsky, Sari; Bateman, Brian T

    2013-12-01

    To define the frequency, risk factors, and outcomes of massive transfusion in obstetrics. The State Inpatient Dataset for New York (1998-2007) was used to identify all delivery hospitalizations for hospitals that reported at least one delivery-related transfusion per year. Multivariable logistic regression analysis was performed to examine the relationship between maternal age, race, and relevant clinical variables and the risk of massive blood transfusion defined as 10 or more units of blood recorded. Massive blood transfusion complicated 6 of every 10,000 deliveries with cases observed even in the smallest facilities. Risk factors with the strongest independent associations with massive blood transfusion included abnormal placentation (1.6/10,000 deliveries, adjusted odds ratio [OR] 18.5, 95% confidence interval [CI] 14.7-23.3), placental abruption (1.0/10,000, adjusted OR 14.6, 95% CI 11.2-19.0), severe preeclampsia (0.8/10,000, adjusted OR 10.4, 95% CI 7.7-14.2), and intrauterine fetal demise (0.7/10,000, adjusted OR 5.5, 95% CI 3.9-7.8). The most common etiologies of massive blood transfusion were abnormal placentation (26.6% of cases), uterine atony (21.2%), placental abruption (16.7%), and postpartum hemorrhage associated with coagulopathy (15.0%). A disproportionate number of women who received a massive blood transfusion experienced severe morbidity including renal failure, acute respiratory distress syndrome, sepsis, and in-hospital death. Massive blood transfusion was infrequent, regardless of facility size. In the presence of known risk for receipt of massive blood transfusion, women should be informed of this possibility, should deliver in a well-resourced facility if possible, and should receive appropriate blood product preparation and venous access in advance of delivery. : II.

  5. Association of Ambient Fine Particles With Out-of-Hospital Cardiac Arrests in New York City

    PubMed Central

    Silverman, Robert A.; Ito, Kazuhiko; Freese, John; Kaufman, Brad J.; De Claro, Danilynn; Braun, James; Prezant, David J.

    2010-01-01

    Cardiovascular morbidity has been associated with particulate matter (PM) air pollution, although the relation between pollutants and sudden death from cardiac arrest has not been established. This study examined associations between out-of-hospital cardiac arrests and fine PM (of aerodynamic diameter ≤2.5 μm, or PM2.5), ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide in New York City. The authors analyzed 8,216 out-of-hospital cardiac arrests of primary cardiac etiology during the years 2002–2006. Time-series and case-crossover analyses were conducted, controlling for season, day-of-week, same-day, and delayed/apparent temperature. An increased risk of cardiac arrest in time-series (relative risk (RR) = 1.06, 95% confidence interval (CI): 1.02, 1.10) and case-crossover (RR = 1.04, 95% CI: 0.99, 1.08) analysis for a PM2.5 increase of 10 μg/m3 in the average of 0- and 1-day lags was found. The association was significant in the warm season (RR = 1.09, 95% CI: 1.03, 1.15) but not the cold season (RR = 1.01, 95% CI: 0.95, 1.07). Associations of cardiac arrest with other pollutants were weaker. These findings, consistent with studies implicating acute cardiovascular effects of PM, support a link between PM2.5 and out-of-hospital cardiac arrests. Since few individuals survive an arrest, air pollution control may help prevent future cardiovascular mortality. PMID:20729350

  6. Impact of the NOx SIP Call on Respiratory Hospitalizations in New York State

    EPA Science Inventory

    Asthma is a serious public health problem in New York State (NYS), affecting 8.4% (370,000) children and 7.6% (more than 1.1 million) adults. Asthma burden in New York's urban areas is consistently higher than the national average, with marked differences in prevalence and seve...

  7. A lean Six Sigma team increases hand hygiene compliance and reduces hospital-acquired MRSA infections by 51%.

    PubMed

    Carboneau, Clark; Benge, Eddie; Jaco, Mary T; Robinson, Mary

    2010-01-01

    A low hand hygiene compliance rate by healthcare workers increases hospital-acquired infections to patients. At Presbyterian Healthcare Services in Albuquerque, New Mexico a Lean Six Sigma team identified the reasons for noncompliance were multifaceted. The team followed the DMAIC process and completed the methodology in 12 months. They implemented multiple solutions in the three areas: Education, Culture, and Environment. Based on methicillin-resistant Staphylococcus aureus (MRSA) mortality research the team's results included an estimated 2.5 lives saved by reducing MRSA infections by 51%. Subsequently this 51% decrease in MRSA saved the hospital US$276,500. For those readers tasked with increasing hand hygiene compliance this article will provide the knowledge and insight needed to overcome multifaceted barriers to noncompliance.

  8. Low prevalence of Pneumocystis pneumonia in hospitalized patients with systemic lupus erythematosus: review of a clinical data warehouse.

    PubMed

    Kapoor, T M; Mahadeshwar, P; Nguyen, S; Li, J; Kapoor, S; Bathon, J; Giles, J; Askanase, A

    2017-12-01

    Objective In the era of powerful immunosuppression, opportunistic infections are an increasing concern in systemic lupus erythematosus. One of the best-studied opportunistic infections is Pneumocystis pneumonia; however, the prevalence of Pneumocystis pneumonia in systemic lupus erythematosus is not clearly defined. This study evaluates the prevalence of Pneumocystis pneumonia in hospitalized systemic lupus erythematosus patients, with a focus on validating the Pneumocystis pneumonia and systemic lupus erythematosus diagnoses with clinical information. Methods This retrospective cohort study evaluates the prevalence of Pneumocystis pneumonia in all systemic lupus erythematosus patients treated at Columbia University Medical Center-New York Presbyterian Hospital between January 2000 and September 2014, using electronic medical record data. Patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and patients with renal transplants (including both early and late post-transplant patients) represented immunocompromised control groups. Patients with systemic lupus erythematosus, Pneumocystis pneumonia, HIV/AIDS, or renal transplant were identified using diagnostic codes from the International Classification of Diseases, Ninth Revision (ICD-9). Results Out of 2013 hospitalized systemic lupus erythematosus patients, nine had presumed Pneumocystis pneumonia, yielding a low prevalence of Pneumocystis pneumonia in systemic lupus erythematosus of 0.45%. Three of the nine Pneumocystis pneumonia cases were patients with concomitant systemic lupus erythematosus and HIV/AIDS. Only one of these nine cases was histologically confirmed as Pneumocystis pneumonia, in a patient with concomitant systemic lupus erythematosus and HIV/AIDS and a CD4 count of 13 cells/mm 3 . The prevalence of Pneumocystis pneumonia in renal transplant patients and HIV/AIDS patients was 0.61% and 5.98%, respectively. Conclusion Given the reported high rate of adverse effects

  9. A Population-Based Cohort Study of Emergency Appendectomy Performed in England and New York State.

    PubMed

    Al-Khyatt, Waleed; Mytton, Jemma; Tan, Benjamin H L; Aquina, Christopher T; Evison, Felicity; Fleming, Fergal J; Pasquali, Sandro; Griffiths, Ewen A; Vohra, Ravinder S

    2017-08-01

    To compare selected outcomes (30-day reoperation and total length of hospital stay) following emergency appendectomy between populations from New York State and England. This retrospective cohort study used demographic and in-hospital outcome data from Hospital Episode Statistics (HES) and the New York Statewide Planning and Research Cooperative System (SPARCS) administrative databases for all patients aged 18+ years undergoing appendectomy between April 2009 and March 2014. Univariate and adjusted multivariable logistic regression were used to test significant factors. A one-to-one propensity score matched dataset was created to compare odd ratios (OR) of reoperations between the two populations. A total of 188,418 patient records, 121,428 (64.4%) from England and 66,990 (35.6%) from NYS, were extracted. Appendectomy was completed laparoscopically in 77.7% of patients in New York State compared to 53.6% in England (P < 0.001). The median lengths of hospital stay for patients undergoing appendectomy were 3 (interquartile range, IQR 2-4) days versus 2 (IQR 1-3) days (P < 0.001) in England and New York State, respectively. All 30-day reoperation rates were higher in England compared to New York State (1.2 vs. 0.6%, P < 0.001), representing nearly a twofold higher risk of 30-day reoperation (OR 1.88, 95% CI 1.64-2.14, P < 0.001). As the proportion of appendectomy completed laparoscopically increased, there was a reduction in the reoperation rate in England (correlation coefficient -0.170, P = 0.036). Reoperations and total length of hospital stay is significantly higher following appendectomy in England compared to New York State. Increasing the numbers of appendectomy completed laparoscopically may decrease length of stay and reoperations.

  10. Excessive heat and respiratory hospitalizations in New York State: estimating current and future public health burden related to climate change.

    PubMed

    Lin, Shao; Hsu, Wan-Hsiang; Van Zutphen, Alissa R; Saha, Shubhayu; Luber, George; Hwang, Syni-An

    2012-11-01

    Although many climate-sensitive environmental exposures are related to mortality and morbidity, there is a paucity of estimates of the public health burden attributable to climate change. We estimated the excess current and future public health impacts related to respiratory hospitalizations attributable to extreme heat in summer in New York State (NYS) overall, its geographic regions, and across different demographic strata. On the basis of threshold temperature and percent risk changes identified from our study in NYS, we estimated recent and future attributable risks related to extreme heat due to climate change using the global climate model with various climate scenarios. We estimated effects of extreme high apparent temperature in summer on respiratory admissions, days hospitalized, direct hospitalization costs, and lost productivity from days hospitalized after adjusting for inflation. The estimated respiratory disease burden attributable to extreme heat at baseline (1991-2004) in NYS was 100 hospital admissions, US$644,069 in direct hospitalization costs, and 616 days of hospitalization per year. Projections for 2080-2099 based on three different climate scenarios ranged from 206-607 excess hospital admissions, US$26-$76 million in hospitalization costs, and 1,299-3,744 days of hospitalization per year. Estimated impacts varied by geographic region and population demographics. We estimated that excess respiratory admissions in NYS due to excessive heat would be 2 to 6 times higher in 2080-2099 than in 1991-2004. When combined with other heat-associated diseases and mortality, the potential public health burden associated with global warming could be substantial.

  11. Reporting of Sepsis Cases for Performance Measurement Versus for Reimbursement in New York State.

    PubMed

    Prescott, Hallie C; Cope, Tara M; Gesten, Foster C; Ledneva, Tatiana A; Friedrich, Marcus E; Iwashyna, Theodore J; Osborn, Tiffany M; Seymour, Christopher W; Levy, Mitchell M

    2018-05-01

    Under "Rory's Regulations," New York State Article 28 acute care hospitals were mandated to implement sepsis protocols and report patient-level data. This study sought to determine how well cases reported under state mandate align with discharge records in a statewide administrative database. Observational cohort study. First 27 months of mandated sepsis reporting (April 1, 2014, to June 30, 2016). Hospitalizations with sepsis at New York State Article 28 acute care hospitals. Sepsis regulations with mandated reporting. We compared cases reported to the New York State Department of Health Sepsis Clinical Database with discharge records in the Statewide Planning and Research Cooperative System database. We classified discharges as 1) "coded sepsis discharges"-a diagnosis code for severe sepsis or septic shock and 2) "possible sepsis discharges," using Dombrovskiy and Angus criteria. Of 111,816 sepsis cases reported to the New York State Department of Health Sepsis Clinical Database, 105,722 (94.5%) were matched to discharge records in Statewide Planning and Research Cooperative System. The percentage of coded sepsis discharges reported increased from 67.5% in the first quarter to 81.3% in the final quarter of the study period (mean, 77.7%). Accounting for unmatched cases, as many as 82.7% of coded sepsis discharges were potentially reported, whereas at least 17.3% were unreported. Compared with unreported discharges, reported discharges had higher rates of acute organ dysfunction (e.g., cardiovascular dysfunction 63.0% vs 51.8%; p < 0.001) and higher in-hospital mortality (30.2% vs 26.1%; p < 0.001). Hospital characteristics (e.g., number of beds, teaching status, volume of sepsis cases) were similar between hospitals with a higher versus lower percent of discharges reported, p values greater than 0.05 for all. Hospitals' percent of discharges reported was not correlated with risk-adjusted mortality of their submitted cases (Pearson correlation coefficient 0.11; p

  12. Excessive Heat and Respiratory Hospitalizations in New York State: Estimating Current and Future Public Health Burden Related to Climate Change

    PubMed Central

    Hsu, Wan-Hsiang; Van Zutphen, Alissa R.; Saha, Shubhayu; Luber, George; Hwang, Syni-An

    2012-01-01

    Background: Although many climate-sensitive environmental exposures are related to mortality and morbidity, there is a paucity of estimates of the public health burden attributable to climate change. Objective: We estimated the excess current and future public health impacts related to respiratory hospitalizations attributable to extreme heat in summer in New York State (NYS) overall, its geographic regions, and across different demographic strata. Methods: On the basis of threshold temperature and percent risk changes identified from our study in NYS, we estimated recent and future attributable risks related to extreme heat due to climate change using the global climate model with various climate scenarios. We estimated effects of extreme high apparent temperature in summer on respiratory admissions, days hospitalized, direct hospitalization costs, and lost productivity from days hospitalized after adjusting for inflation. Results: The estimated respiratory disease burden attributable to extreme heat at baseline (1991–2004) in NYS was 100 hospital admissions, US$644,069 in direct hospitalization costs, and 616 days of hospitalization per year. Projections for 2080–2099 based on three different climate scenarios ranged from 206–607 excess hospital admissions, US$26–$76 million in hospitalization costs, and 1,299–3,744 days of hospitalization per year. Estimated impacts varied by geographic region and population demographics. Conclusions: We estimated that excess respiratory admissions in NYS due to excessive heat would be 2 to 6 times higher in 2080–2099 than in 1991–2004. When combined with other heat-associated diseases and mortality, the potential public health burden associated with global warming could be substantial. PMID:22922791

  13. Detection of Practice Pattern Trends through Natural Language Processing of Clinical Narratives and Biomedical Literature

    PubMed Central

    Chen, Elizabeth S.; Stetson, Peter D.; Lussier, Yves A.; Markatou, Marianthi; Hripcsak, George; Friedman, Carol

    2007-01-01

    Clinical knowledge, best evidence, and practice patterns evolve over time. The ability to track these changes and study practice trends may be valuable for performance measurement and quality improvement efforts. The goal of this study was to assess the feasibility and validity of methods to generate and compare trends in biomedical literature and clinical narrative. We focused on the challenge of detecting trends in medication usage over time for two diseases: HIV/AIDS and asthma. Information about disease-specific medications in published randomized control trials and discharge summaries at New York-Presbyterian Hospital over a ten-year period were extracted using Natural Language Processing. This paper reports on the ability of our semi-automated process to discover disease-drug practice pattern trends and interpretation of findings across the biomedical and clinical text sources. PMID:18693810

  14. Management of Patients with Cardiac Arrest Complicating Myocardial Infarction in New York Before and After Public Reporting Policy Changes

    PubMed Central

    Strom, Jordan B.; McCabe, James M.; Waldo, Stephen W.; Pinto, Duane; Kennedy, Kevin F.; Feldman, Dmitriy N.; Yeh, Robert W.

    2017-01-01

    Background In 2010, New York State began excluding selected patients with cardiac arrest and coma from publicly reported mortality statistics after percutaneous coronary intervention (PCI). We evaluated the effects of this exclusion on rates of coronary angiography, revascularization, and mortality among patients with acute myocardial infarction (AMI) and cardiac arrest. Methods and Results Using statewide hospitalization files, we identified discharges for AMI and cardiac arrest 1/2003–12/2013 in New York and several comparator states. A difference-in-differences approach was used to evaluate the likelihood of coronary angiography, revascularization, and in-hospital mortality before and after 2010. A total of 26,379 patients with AMI and cardiac arrest (5,619 in New York) were included. Of these, 17,141 (65%) underwent coronary angiography, 12,183 (46.2%) underwent PCI and 2,832 (10.7%) underwent CABG. Prior to 2010, cardiac arrest patients in New York were less likely to undergo PCI compared with referent states (aRR 0.79, 95% CI 0,73–0.85, p<0.001). This relationship was unchanged after the policy change (aRR 0.82, 95% CI 0.76–0.89, interaction p = 0.359). Adjusted risks of in-hospital mortality between New York and comparator states after 2010 were also similar (aRR 0.94, 95% CI 0.87–1.02, p = 0.152 for post- vs. pre-2010 in New York, aRR 0.88, 95% CI 0.84–0.92, p <0.001 for comparator states; interaction p = 0.103). Conclusions Exclusion of selected cardiac arrest cases from public reporting was not associated with changes in rates of PCI or in-hospital mortality in New York. Rates of revascularization in New York for cardiac arrest patients were lower throughout. PMID:28495895

  15. Management of Patients With Cardiac Arrest Complicating Myocardial Infarction in New York Before and After Public Reporting Policy Changes.

    PubMed

    Strom, Jordan B; McCabe, James M; Waldo, Stephen W; Pinto, Duane S; Kennedy, Kevin F; Feldman, Dmitriy N; Yeh, Robert W

    2017-05-01

    In 2010, New York State began excluding selected patients with cardiac arrest and coma from publicly reported mortality statistics after percutaneous coronary intervention. We evaluated the effects of this exclusion on rates of coronary angiography, revascularization, and mortality among patients with acute myocardial infarction and cardiac arrest. Using statewide hospitalization files, we identified discharges for acute myocardial infarction and cardiac arrest January 2003 to December 2013 in New York and several comparator states. A difference-in-differences approach was used to evaluate the likelihood of coronary angiography, revascularization, and in-hospital mortality before and after 2010. A total of 26 379 patients with acute myocardial infarction and cardiac arrest (5619 in New York) were included. Of these, 17 141 (65%) underwent coronary angiography, 12 183 (46.2%) underwent percutaneous coronary intervention, and 2832 (10.7%) underwent coronary artery bypass grafting. Before 2010, patients with cardiac arrest in New York were less likely to undergo percutaneous coronary intervention compared with referent states (adjusted relative risk, 0.79; 95% confidence interval, 0.73-0.85; P <0.001). This relationship was unchanged after the policy change (adjusted relative risk, 0.82; 95% confidence interval, 0.76-0.89; interaction P =0.359). Adjusted risks of in-hospital mortality between New York and comparator states after 2010 were also similar (adjusted relative risk, 0.94; 95% confidence interval, 0.87-1.02; P =0.152 for post- versus pre-2010 in New York; adjusted relative risk, 0.88; 95% confidence interval, 0.84-0.92; P <0.001 for comparator states; interaction P =0.103). Exclusion of selected cardiac arrest cases from public reporting was not associated with changes in rates of percutaneous coronary intervention or in-hospital mortality in New York. Rates of revascularization in New York for cardiac arrest patients were lower throughout. © 2017

  16. Hospitalization event notifications and reductions in readmissions of Medicare fee-for-service beneficiaries in the Bronx, New York.

    PubMed

    Unruh, Mark Aaron; Jung, Hye-Young; Kaushal, Rainu; Vest, Joshua R

    2017-04-01

    Follow-up with a primary care provider after hospital discharge has been associated with a reduced likelihood of readmission. However, primary care providers are frequently unaware of their patients' hospitalizations. Event notification may be an effective tool for reducing readmissions by notifying primary care providers when their patients have been admitted to and discharged from a hospital. We examined the effect of an event notification system on 30-day readmissions in the Bronx, New York. The Bronx has among the highest readmission rates in the country and is a particularly challenging setting to improve care due to the low socioeconomic status of the county and high rates of poor health behaviors among its residents. The study cohort included 2559 Medicare fee-for-service beneficiaries associated with 14 141 hospital admissions over the period January 2010 through June 2014. Linear regression models with beneficiary-level fixed-effects were used to estimate the impact of event notifications on readmissions by comparing the likelihood of rehospitalization for a beneficiary before and after event notifications were active. The unadjusted 30-day readmission rate when event notifications were not active was 29.5% compared to 26.5% when alerts were active. Regression estimates indicated that active hospitalization alert services were associated with a 2.9 percentage point reduction in the likelihood of readmission (95% confidence interval: -5.5, -0.4). Alerting providers through event notifications may be an effective tool for improving the quality and efficiency of care among high-risk populations. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  17. Deaths and severe adverse events associated with anesthesia-assisted rapid opioid detoxification--New York City, 2012.

    PubMed

    2013-09-27

    During August-September 2012, the New York City Department of Health and Mental Hygiene (DOHMH) was notified by the New York City Poison Control Center regarding three patients who experienced serious adverse events after anesthesia-assisted rapid opiate detoxification (AAROD) at a local outpatient clinic. All three patients required hospitalization, and one subsequently died. DOHMH issued an order requiring that the clinic cease performing AAROD pending an investigation and searched for additional cases of AAROD-related serious adverse events at the clinic and elsewhere in New York City for the period September 2011 to September 2012. That search found no serious adverse events at clinics other than the one implicated. Of the 75 patients who underwent AAROD at the implicated clinic during January-September 2012, two died, and five others experienced serious adverse events requiring hospitalization. As a result of the findings, the New York State Department of Health, the New York Office of Alcoholism and Substance Abuse Services, and DOHMH jointly issued a Health Alert informing New York health-care providers of AAROD-associated serious adverse events and recommending that they avoid use of AAROD in favor of evidence-based options for opioid dependence treatment.

  18. New York, New York

    ERIC Educational Resources Information Center

    Santos, Thomas W.

    2008-01-01

    This article describes New York City. It presents information about its history, immigration process, geography, architecture, rivers, bridges, famous buildings and parks, famous neighborhoods, arts and entertainment, and tourist attractions and activities. The article also provides useful websites about New York City. It ends with a text about…

  19. Epidemiology of motor vehicle injuries in Suffolk County, New York before and after enactment of the New York state seat belt use law

    DOT National Transportation Integrated Search

    1989-06-01

    A population-based study of hospital and medical examiner reported vehicular trauma was conducted to determine the efficacy of the New York Law which compared pre-law 1984 occurrence and severity patterns with those of post-law 1985. Vehicles and occ...

  20. Seasonal and temperature modifications of the association between fine particulate air pollution and cardiovascular hospitalization in New York state.

    PubMed

    Hsu, Wan-Hsiang; Hwang, Syni-An; Kinney, Patrick L; Lin, Shao

    2017-02-01

    It is known that extreme temperature and ambient air pollution are each independently associated with human health outcomes. However, findings from the few studies that have examined modified effects by seasons and the interaction between air pollution and temperature on health endpoints are inconsistent. This study examines the effects of short-term PM 2.5 (particulate matter less than or equal to 2.5μm in aerodynamic diameter) on hospitalization for cardiovascular diseases (CVDs), its modifications by season and temperature, and whether these effects are heterogeneous across different regions in New York State (NYS). We used daily average temperature and PM 2.5 concentrations as exposure indicators and performed a time series analysis with a quasi-Poisson model, controlling for possible confounders, such as time-relevant variables and dew point, for CVDs in NYS, 1991-2006. Stratification parametric models were applied to evaluate the modifying effects by seasons and temperature. Across the whole year, a 10-μg/m 3 increment in PM 2.5 concentration accounted for a 1.37% increase in CVDs (95% confidence interval (CI): 0.90%, 1.84%) in New York City, Long Island & Hudson. The PM 2.5 effect was strongest in winter, with an additional 2.06% (95% CI: 1.33%, 2.80%) increase in CVDs observed per 10-μg/m 3 increment in PM 2.5 . Temperature modified the PM 2.5 effects on CVDs, and these modifications by temperature on PM 2.5 effects on CVDs were found at low temperature days. These associations were heterogeneous across four PM 2.5 concentration regions. PM 2.5 was positively associated with CVD hospitalizations. The short-term PM 2.5 effect varied with season and temperature levels, and stronger effects were observed in winter and at low temperature days. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Transforming the Primary Care Training Clinic: New York State's Hospital Medical Home Demonstration Pilot.

    PubMed

    Angelotti, Marietta; Bliss, Kathryn; Schiffman, Dana; Weaver, Erin; Graham, Laura; Lemme, Thomas; Pryor, Veronica; Gesten, Foster C

    2015-06-01

    Training in patient-centered medical home (PCMH) settings may prepare new physicians to measure quality of care, manage the health of populations, work in teams, and include cost information in decision making. Transforming resident clinics to PCMHs requires funding for additional staff, electronic health records, training, and other resources not typically available to residency programs. Describe how a 1115 Medicaid waiver was used to transform the majority of primary care training sites in New York State to the PCMH model and improve the quality of care provided. The 2013-2014 Hospital Medical Home Program provided awards to 60 hospitals and 118 affiliated residency programs (training more than 5000 residents) to transform outpatient sites into PCMHs and provide high-quality, coordinated care. Site visits, coaching calls, resident surveys, data reporting, and feedback were used to promote and monitor change in resident continuity and quality of care. Descriptive analyses measured improvements in these areas. A total of 156 participating outpatient sites (100%) received PCMH recognition. All sites enhanced resident education using PCMH principles through patient empanelment, development of quality dashboards, and transforming resident scheduling and training. Clinical quality outcomes showed improvement across the demonstration, including better performance on colorectal and breast cancer screening rates (rate increases of 13%, P≤.001, and 11%, P=.011, respectively). A 1115 Medicaid waiver is a viable mechanism for states to transform residency clinics to reflect new primary care models. The PCMH transformation of 156 sites led to improvements in resident continuity and clinical outcomes.

  2. Herbert Rackow and Ernest Salanitre: the emergence of pediatric anesthesia as a specialty in the United States.

    PubMed

    Friesen, Robert H

    2015-07-01

    Herbert Rackow and Ernest Salanitre were pediatric anesthesiologists at Babies Hospital at the Columbia-Presbyterian Medical Center in New York whose work spanned three decades beginning in the early 1950s. Their pioneering research included studies of the uptake and elimination of inhalational anesthetics and of the risk of cardiac arrest in infants and children. They were actively involved in the development of pediatric anesthesia as a specialty, and their efforts contributed to inter-disciplinary collaboration and to the formation of the Section on Anesthesiology of the American Academy of Pediatrics. Their 1969 review article, 'Modern Concepts in Pediatric Anesthesiology', provides a fascinating view of pediatric anesthesia 50 years ago. In 1990, they were jointly awarded the Robert M. Smith award by the Section on Anesthesiology of the American Academy of Pediatrics. © 2015 John Wiley & Sons Ltd.

  3. Fractures in Kidney Transplant Recipients: A Comparative Study Between England and New York State.

    PubMed

    Arnold, Julia; Mytton, Jemma; Evison, Felicity; Gill, Paramjit S; Cockwell, Paul; Sharif, Adnan; Ferro, Charles J

    2017-11-15

    Fractures are associated with high morbidity and are a major concern for kidney transplant recipients. No comparative analysis has yet been conducted between countries in the contemporary era to inform future international prevention trials. Data were obtained from the Hospital Episode Statistics and the Statewide Planning and Research Cooperative databases on all adult kidney transplants performed in England and New York State from 2003 to 2013, respectively, and on posttransplant fracture-related hospitalization from 2003 to 2014. Our analysis included 18 493 English and 11 602 New York State kidney transplant recipients. Overall, 637 English recipients (3.4%) and 398 New York State recipients (3.4%) sustained a fracture, giving an unadjusted event rate of 7.0 and 5.9 per 1000 years, respectively (P = .948). Of these, 147 English (0.8%) and 101 New York State recipients (0.9%) sustained a hip fracture, giving an unadjusted event rate of 1.6 and 1.5 per 1000 years, respectively (P = .480). There were no differences in the cumulative incidence of all fractures or hip fractures. One-year mortality rates after any fracture (9% and 11%) or after a hip fracture (15% and 17%) were not different between cohorts. Contemporaneous English and New York State kidney transplant recipients have similar fracture rates and mortality rates postfracture.

  4. The New York Sepsis Severity Score: Development of a Risk-Adjusted Severity Model for Sepsis.

    PubMed

    Phillips, Gary S; Osborn, Tiffany M; Terry, Kathleen M; Gesten, Foster; Levy, Mitchell M; Lemeshow, Stanley

    2018-05-01

    In accordance with Rory's Regulations, hospitals across New York State developed and implemented protocols for sepsis recognition and treatment to reduce variations in evidence informed care and preventable mortality. The New York Department of Health sought to develop a risk assessment model for accurate and standardized hospital mortality comparisons of adult septic patients across institutions using case-mix adjustment. Retrospective evaluation of prospectively collected data. Data from 43,204 severe sepsis and septic shock patients from 179 hospitals across New York State were evaluated. Prospective data were submitted to a database from January 1, 2015, to December 31, 2015. None. Maximum likelihood logistic regression was used to estimate model coefficients used in the New York State risk model. The mortality probability was estimated using a logistic regression model. Variables to be included in the model were determined as part of the model-building process. Interactions between variables were included if they made clinical sense and if their p values were less than 0.05. Model development used a random sample of 90% of available patients and was validated using the remaining 10%. Hosmer-Lemeshow goodness of fit p values were considerably greater than 0.05, suggesting good calibration. Areas under the receiver operator curve in the developmental and validation subsets were 0.770 (95% CI, 0.765-0.775) and 0.773 (95% CI, 0.758-0.787), respectively, indicating good discrimination. Development and validation datasets had similar distributions of estimated mortality probabilities. Mortality increased with rising age, comorbidities, and lactate. The New York Sepsis Severity Score accurately estimated the probability of hospital mortality in severe sepsis and septic shock patients. It performed well with respect to calibration and discrimination. This sepsis-specific model provides an accurate, comprehensive method for standardized mortality comparison of adult

  5. Early primary care follow-up after ED and hospital discharge - does it affect readmissions?

    PubMed

    Sinha, Sanjai; Seirup, Joanna; Carmel, Amanda

    2017-04-01

    After hospitalization, timely discharge follow-up has been linked to reduced readmissions in the heart failure population, but data from general inpatients has been mixed. The objective of this study was to determine if there was an association between completed follow-up appointments within 14 days of hospital discharge and 30-day readmission amongst primary care patients at an urban academic medical center. Index discharges included both inpatient and emergency room settings. A secondary objective was to identify patient factors associated with completed follow-up appointments within 14 days. We conducted a retrospective review of primary care patients at an urban academic medical center who were discharged from either the emergency department (ED) or inpatient services at the Weill Cornell Medical Center/New York Presbyterian Hospital from 1 January 2014-31 December 2014. Cox proportional hazard models were used to identify the relationship between follow-up in primary care within 14 days and readmission within 30 days. Logistic regression was used to evaluate the association of patient factors with 14-day follow-up. Among 9,662 inpatient and ED discharges, multivariable analysis (adjusting for age, gender, race/ethnicity, insurance, number of diagnoses on problem list, length of stay, and discharge service) showed that follow-up with primary care within 14 days was not associated with a lower hazard of readmission within 30 days (HR = 0.78; 95% CI 0.56-1.09). A higher number of diagnoses on the problem list was associated with greater odds of follow-up for both inpatient and emergency department discharges (inpatient: HR = 1.03, 95% CI 1.02-1.04; ED: HR = 1.02, 95% CI 1.00-1.04). For inpatient discharges, each additional day in length of stay was associated with 3% lower odds of follow-up (HR = 0.97, 95% CI 0.96-0.99). Early follow-up within 14 days after discharge from general inpatient services was associated with a trend toward lower hazard of

  6. Hospital emergency department visits for carbon monoxide poisoning following an October 2006 snowstorm in western New York.

    PubMed

    Muscatiello, Neil A; Babcock, Gwen; Jones, Rena; Horn, Edward; Hwang, Syni-An

    2010-01-01

    Following an October 2006 snowstorm that caused widespread power outages in western New York State, hospital emergency department (ED) visits for carbon monoxide (CO) poisoning increased. Overall, 264 people representing 155 households were diagnosed with CO poisoning during the power outages. Telephone interviews were conducted with a subset of these individuals. Respondents provided information about exposure sources, CO alarms, and awareness of CO warnings. In many households, portable generators were operated in an enclosed area. Awareness of CO warnings may have contributed to knowledge about locating portable generators outside. When operated outside, however, portable generators were generally located too close to the home. Gas kitchen ranges were used for heat by numerous households. In the short term, CO education and improved clarity of CO warning information is important for increasing awareness about power outage-related CO risks. Improvements in the combustion efficiency of portable generators should be a long-term goal.

  7. Streptococcal sore throat followup program in a hospital clinic, New York City.

    PubMed Central

    Kaufman, A; Murray, D; Starita, L; Brickner, P W

    1975-01-01

    To improve followup and treatment of patients with streptococcal sore throat at St. Vincent's Hospital and Medical Center, New York City, a simple and inexpensive method was devised for recalling and treating untreated patients with positive throat cultures and culturing household contacts. The program was conducted by a clinic nurse and a secretary, with only occasional assistance from a physician. All services were free for those without Medicaid coverage. The secretary sent notification letters to all patients with positive cultures urging them to return for treatment and emphasizing the need for their contacts to come for screening. The secretary, trained in the throat culturing technique, also performed the laboratory work on the cultures from contacts. The clinic nurse swabbed the throats of all contacts and administered treatment, according to a standing-order protocol, to all with culture-proved streptococcal sore throat. A comparison of initially untreated patients with positive cultures seen 3 months before and 6 months after the program was started revealed that 46 percent returned for treatment after the notification letter was sent; before the program only 21 percent returned for treatment. No attempt had been made to reach household contacts before the program began. The rate of streptococcal sore throat in contacts was 14 percent, and in the clinic patients it was 11 percent during the first 6 months of the program. Images p369-a p371-a PMID:808824

  8. Association of Hospitalization for Neurosurgical Operations in Magnet Hospitals With Mortality and Length of Stay.

    PubMed

    Missios, Symeon; Bekelis, Kimon

    2018-03-01

    The association of Magnet hospital status with improved surgical outcomes remains an issue of debate. To investigate whether hospitalization in a Magnet hospital is associated with improved outcomes for patients undergoing neurosurgical operations. A cohort study was executed using all patients undergoing neurosurgical operations in New York registered in the Statewide Planning and Research Cooperative System database from 2009 to 2013. We examined the association of Magnet status hospitalization after neurosurgical operations with inpatient case fatality and length of stay (LOS). We employed an instrumental variable analysis to simulate a randomized trial. Overall, 190 787 patients underwent neurosurgical operations. Of these, 68 046 (35.7%) were hospitalized in Magnet hospitals, and 122 741 (64.3%) in non-Magnet institutions. Instrumental variable analysis demonstrated that hospitalization in Magnet hospitals was associated with decreased case fatality (adjusted difference, -0.8%; -95% confidence interval, -0.7% to -0.6%), and LOS (adjusted difference, -1.9; 95% confidence interval, -2.2 to -1.5) in comparison to non-Magnet hospitals. These associations were also observed in propensity score adjusted mixed effects models. These associations persisted in prespecified subgroups of patients undergoing spine surgery, craniotomy for tumor resection, or neurovascular interventions. We identified an association of Magnet hospitals with lower case fatality, and shorter LOS in a comprehensive New York State patient cohort undergoing neurosurgical procedures. Copyright © 2017 by the Congress of Neurological Surgeons

  9. Promoting Teen Health and Reducing Risks: A Look at Adolescent Health Services in New York City.

    ERIC Educational Resources Information Center

    Citizens' Committee for Children of New York, NY.

    This study examined data from focus groups with New York City adolescents and interviews with health care providers serving New York City adolescents (hospital based clinics, school based health centers, child health clinics, community health centers, and a multi-service adolescent center) in order to determine how to promote health and reduce…

  10. A Comparison of Mortality Following Emergency Laparotomy Between Populations From New York State and England.

    PubMed

    Tan, Benjamin H L; Mytton, Jemma; Al-Khyatt, Waleed; Aquina, Christopher T; Evison, Felicity; Fleming, Fergal J; Griffiths, Ewen; Vohra, Ravinder S

    2017-08-01

    The aim of this study was to compare mortality following emergency laparotomy between populations from New York State and England. Mortality following emergency surgery is a key quality improvement metric in both the United States and UK. Comparison of the all-cause 30-day mortality following emergency laparotomy between populations from New York State and England might identify factors that could improve care. Patient demographics, in-hospital, and 30-day outcomes data were extracted from Hospital Episode Statistics (HES) in England and the New York Statewide Planning and Research Cooperative System (SPARCS) administrative databases for all patients older than 18 years undergoing laparotomy for emergency open bowel surgery between April 2009 and March 2014. The primary outcome measure was all-cause mortality within 30 days of the index laparotomy. Mixed-effects logistic regression was performed to model independent demographic variables against mortality. A one-to-one propensity score matched dataset was created to compare the odd ratios of mortality between the 2 populations. Overall, 137,869 patient records, 85,286 (61.9%) from England and 52,583 (38.1%) from New York State, were extracted. Crude 30-day mortality for patients was significantly higher in the England compared with New York State [11,604 (13.6%) vs 3633 (6.9%) patients, P < 0.001]. Patients undergoing emergency laparotomy in England had significantly higher risk of mortality compared with those in New York State (odds ratio 2.35, confidence interval 2.24-2.46, P < 0.001). The risk of mortality at 30 days is higher following emergency laparotomy in England as compared with New York State despite similar patient groups.

  11. Designing a Clinical Data Warehouse Architecture to Support Quality Improvement Initiatives.

    PubMed

    Chelico, John D; Wilcox, Adam B; Vawdrey, David K; Kuperman, Gilad J

    2016-01-01

    Clinical data warehouses, initially directed towards clinical research or financial analyses, are evolving to support quality improvement efforts, and must now address the quality improvement life cycle. In addition, data that are needed for quality improvement often do not reside in a single database, requiring easier methods to query data across multiple disparate sources. We created a virtual data warehouse at NewYork Presbyterian Hospital that allowed us to bring together data from several source systems throughout the organization. We also created a framework to match the maturity of a data request in the quality improvement life cycle to proper tools needed for each request. As projects progress in the Define, Measure, Analyze, Improve, Control stages of quality improvement, there is a proper matching of resources the data needs at each step. We describe the analysis and design creating a robust model for applying clinical data warehousing to quality improvement.

  12. Factors associated with variation in financial condition among voluntary hospitals.

    PubMed Central

    Brecher, C; Nesbitt, S

    1985-01-01

    This article uses multiple regression analysis to identify factors which affect variations in the financial condition of voluntary hospitals in New York State. Six separate ratios are used to measure financial condition and 18 independent variables are considered. The factors affecting financial conditions were found to vary among dimensions of financial health, and different causal relationships were evident among hospitals in New York City than among those in the rest of the state. PMID:4019212

  13. Association of hospitalization for neurosurgical operations in Magnet hospitals with mortality and length-of-stay

    PubMed Central

    Missios, Symeon; Bekelis, Kimon

    2017-01-01

    Background The association of Magnet hospital status with improved surgical outcomes remains an issue of debate. Objective To investigate whether hospitalization in a Magnet hospital is associated with improved outcomes for patients undergoing neurosurgical operations. Methods A cohort study was executed using all patients undergoing neurosurgical operations in New York registered in the Statewide Planning and Research Cooperative System (SPARCS) database from 2009–2013. We examined the association of Magnet status hospitalization after neurosurgical operations with inpatient case-fatality, and length of stay (LOS). We employed an instrumental variable analysis to simulate a randomized trial. Results Overall, 190,787 patients underwent neurosurgical operations. Of these, 68,046 (35.7%) were hospitalized in Magnet hospitals, and 122,741 (64.3%) in non-Magnet institutions. Instrumental variable analysis demonstrated that hospitalization in Magnet hospitals was associated with decreased case-fatality (Adjusted difference, −0.8%; −95% CI, −0.7% to −0.6%), and LOS (Adjusted difference, −1.9; 95% CI, −2.2 to −1.5) in comparison to non-Magnet hospitals. These associations were also observed in propensity score adjusted mixed effects models. These associations persisted in pre-specified subgroups of patients undergoing spine surgery, craniotomy for tumor resection, or neurovascular interventions. Conclusions We identified an association of Magnet hospitals with lower case-fatality, and shorter LOS in a comprehensive New York State patient cohort undergoing neurosurgical procedures. PMID:28472336

  14. Utilization and Short-Term Outcomes of Primary Total Hip and Knee Arthroplasty in the United States and Canada: An Analysis of New York and Ontario Administrative Data.

    PubMed

    Cram, Peter; Landon, Bruce E; Matelski, John; Ling, Vicki; Stukel, Therese A; Paterson, J Michael; Gandhi, Rajiv; Hawker, Gillian A; Ravi, Bheeshma

    2018-04-01

    Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are common and effective surgical procedures. This study sought to compare utilization and short-term outcomes of primary TKA and THA in adjacent regions of Canada and the United States. The study was designed as a retrospective cohort study of patients who underwent primary TKA or THA, comparing administrative data from New York and Ontario in 2012-2013. Demographic features of the TKA and THA patients, per capita utilization rates, and short-term outcomes were compared between the jurisdictions. A higher percentage of New York hospitals performed TKA compared to Ontario hospitals (75.7% versus 42.1%; P < 0.001), and the mean annual procedural volume for TKAs was lower in New York hospitals (mean 179 versus 327 in Ontario hospitals; P < 0.001). After direct standardization, utilization was significantly lower in New York compared to Ontario, both for TKA (16.1 TKAs versus 21.4 TKAs per 10,000 population per year; P < 0.001) and for THA (10.5 THAs versus 11.5 THAs per 10,000 population per year; P < 0.001). For those who underwent TKA, the length of stay in Ontario hospitals was significantly longer (mean 3.7 days versus 3.4 days in New York hospitals; P < 0.001). A smaller percentage of New York patients were discharged directly home (46.2% versus 90.9% of Ontario patients; P < 0.001), but 30-day and 90-day readmission rates were higher in New York compared to Ontario (30-day rates, 4.6% versus 3.9% [P < 0.001]; 90-day rates, 8.4% versus 6.7% [P < 0.001]). For the THA cohorts, the results with regard to length of stay, discharge disposition, and readmission rates were similar to those for TKA. Ontario has higher utilization of total joint arthroplasty than New York but has a smaller percentage of hospitals performing these procedures. Patients are more likely to be discharged home and less likely to be readmitted in Ontario. Our results suggest areas where each jurisdiction could improve. © 2017

  15. WebCIS: large scale deployment of a Web-based clinical information system.

    PubMed

    Hripcsak, G; Cimino, J J; Sengupta, S

    1999-01-01

    WebCIS is a Web-based clinical information system. It sits atop the existing Columbia University clinical information system architecture, which includes a clinical repository, the Medical Entities Dictionary, an HL7 interface engine, and an Arden Syntax based clinical event monitor. WebCIS security features include authentication with secure tokens, authorization maintained in an LDAP server, SSL encryption, permanent audit logs, and application time outs. WebCIS is currently used by 810 physicians at the Columbia-Presbyterian center of New York Presbyterian Healthcare to review and enter data into the electronic medical record. Current deployment challenges include maintaining adequate database performance despite complex queries, replacing large numbers of computers that cannot run modern Web browsers, and training users that have never logged onto the Web. Although the raised expectations and higher goals have increased deployment costs, the end result is a far more functional, far more available system.

  16. Myocardial Revascularization in New York State: Variations in the PCI-to-CABG Ratio and Their Implications.

    PubMed

    Ko, Wilson; Tranbaugh, Robert; Marmur, Jonathan D; Supino, Phyllis G; Borer, Jeffrey S

    2012-04-01

    During the past 2 decades, percutaneous coronary intervention (PCI) has increased dramatically compared with coronary artery bypass grafting (CABG) for patients with coronary artery disease. However, although the evidence available to all practitioners is similar, the relative distribution of PCI and CABG appears to differ among hospitals and regions. We reviewed the published data from the mandatory New York State Department of Health annual cardiac procedure reports issued from 1994 through 2008 to define trends in PCI and CABG utilization in New York and to compare the PCI/CABG ratios in the metropolitan area to the remainder of the State. During this 15-year interval, the procedure volume changes for CABG, for all cardiac surgeries, for non-CABG cardiac surgeries, and for PCI for New York State were -40%, -20%, +17.5%, and +253%, respectively; for the Manhattan programs, the changes were similar as follows: -61%, -23%, +14%, and +284%. The average PCI/CABG ratio in New York State increased from 1.12 in 1994 to 5.14 in 2008; however, in Manhattan, the average PCI/CABG ratio increased from 1.19 to 8.04 (2008 range: 3.78 to 16.2). The 2008 PCI/CABG ratios of the Manhattan programs were higher than the ratios for New York City programs outside Manhattan, in Long Island, in the northern counties contiguous to New York City, and in the rest of New York State; their averages were 5.84, 5.38, 3.31, and 3.24, respectively. In Manhattan, a patient had a 56% greater chance of receiving PCI than CABG as compared with the rest of New York State; in one Manhattan program, the likelihood was 215% higher. There are substantial regional and statewide differences in the utilization of PCI versus CABG among cardiac centers in New York, possibly related to patient characteristics, physician biases, and hospital culture. Understanding these disparities may facilitate the selection of the most appropriate, effective, and evidence-based revascularization strategy. (J Am Heart Assoc

  17. New York City's Child Health Clinics: Providing Quality Primary Care to Children in Low-Income and Immigrant Families.

    ERIC Educational Resources Information Center

    Citizens' Committee for Children of New York, NY.

    A study was conducted to determine whether the New York City Health and Hospitals Corporation (HHC) is fulfilling dual public health and primary care missions of its Child Health Clinics, which provide services to 78,000 New York City children every year. Among the services provided by Child Health Clinics are health examinations for school and…

  18. The New York State cardiac registries: history, contributions, limitations, and lessons for future efforts to assess and publicly report healthcare outcomes.

    PubMed

    Hannan, Edward L; Cozzens, Kimberly; King, Spencer B; Walford, Gary; Shah, Nirav R

    2012-06-19

    In 1988, the New York State Health Commissioner was confronted with hospital-level data demonstrating very large, multiple-year, interhospital variations in short-term mortality and complications for cardiac surgery. The concern with the extent to which these differences were due to variations in patients' pre-surgical severity of illness versus hospitals' quality of care led to the development of clinical registries for cardiac surgery in 1989 and for percutaneous coronary interventions in 1992 in New York. In 1990, the Department of Health released hospitals' risk-adjusted cardiac surgery mortality rates for the first time, and shortly thereafter, similar data were released for hospitals and physicians for percutaneous coronary interventions, cardiac valve surgery, and pediatric cardiac surgery (only hospital data). This practice is still ongoing. The purpose of this communication is to relate the history of this initiative, including changes or purported changes that have occurred since the public release of cardiac data. These changes include decreases in risk-adjusted mortality, cessation of cardiac surgery in New York by low-volume and high-mortality surgeons, out-of-state referral or avoidance of cardiac surgery/angioplasty for high-risk patients, alteration of contracting choices by insurance companies, and modifications in market share of cardiac hospitals. Evidence related to these impacts is reviewed and critiqued. This communication also includes a summary of numerous studies that used New York's cardiac registries to examine a variety of policy issues regarding the choice and use of cardiac procedures, the comparative effectiveness of competing treatment options, and the examination of the relationship among processes, structures, and outcomes of cardiac care. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  19. Climate Science for Decision-Making in the New York Metropolitan Region. Chapter 3

    NASA Technical Reports Server (NTRS)

    Horton, Radley; Rosenzweig, Cynthia; Solecki, William; Bader, Daniel; Sohl, Linda

    2016-01-01

    New York City is one of the world's most vulnerable cities to coastal flooding, due to a high concentration of population and assets near a coastline exposed to warm-season tropical storms and cold -season Nor'easter storms. Among U.S. cities, New York City is second only to New Orleans in population living less than 4 ft above the local high tide. By the 2050s, average annual losses due to coastal flooding alone could exceed $2 billion for the combined New York City-Newark region. Perhaps the most iconic example of a vulnerable New York City asset is the financial district located at the southern tip of Manhattan, however low-lying coastal assets include the full complement of major highways, subways and tunnels, hospitals, schools, wastewater treatment plants, food distribution centers, and people's homes. Given the magnitude of the assets at risk, a compelling case can be made that long-term adaptation makes economic sense for New York City. Given New York's access to economic, human, and technological resources for resilience measures, the City may be able to achieve this resilience. The city's political environment-New York City is a place where climate science is generally not a partisan issue-and the city's experience with uncertainty and overall risk framing (e.g., financing of bond issues for multi-billion dollar infrastructure with multidecade expected lifetimes), encourage climate risk framing.

  20. Drama Therapies in Hospitals

    ERIC Educational Resources Information Center

    Goodman, Judith; Prosperi, Mario

    1976-01-01

    Explores the use of drama as a therapeutic tool at various hospitals and records specific therapy groups dialogues. Available from: The Drama Review, 51 West 4th Street, Room 300, New York, N.Y. 10012. Subscription Rates: $12.50 per year. (MH)

  1. Long-term Energy and Emissions Savings Potential in New York City Buildings

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bhatt, Vatsal; Lee, John; Klein, Yehuda

    2012-09-30

    The New York State Energy Research and Development Authority (NYSERDA) partnered with the Brookhaven National Laboratory (BNL) and the City University of New York (CUNY) to develop an integrated methodology that is capable of quantifying the impact of energy efficiency and load management options in buildings, including CUNY’s campus buildings, housing projects, hospitals, and hotels, while capturing the synergies and offsets in a complex and integrated energy-environmental system. The results of this work serve as a guideline in implementing urban energy efficiency and other forms of urban environmental improvement through cost-effective planning at the institutional and local level.

  2. The Clinical Quality Fellowship Program: Developing Clinical Quality Leadership in the Greater New York Region.

    PubMed

    Bhalla, Rohit; Jalon, Hillary S; Ryan, Lorraine

    The Institute of Medicine has noted that a key factor underlying patient safety problems in the United States is a paucity of quality and safety training programs for clinicians. The Greater New York Hospital Association and United Hospital Fund created the Clinical Quality Fellowship Program (CQFP) to develop quality improvement leaders in the New York region. The goals of this article are to describe the CQFP's structure and curriculum, program participants' perceived value, improvement projects, and career paths. Eighty-seven participants completed the CQFP from 2010 to 2014. Among program participants completing self-assessment evaluations, significant improvements were observed across all quality improvement skill areas. Capstone project categories included inpatient efficiency, transitional care, and hospital infection. Fifty-six percent of participants obtained promotions following program completion. A training program emphasizing diverse curricular elements, varied learning approaches, and applied improvement projects increased participants' self-perceived skills, generated diverse improvement initiatives, and was associated with career advancement.

  3. Patient-Centered Care Transition for Patients Admitted through the ED: Improving Patient and Employee Experience

    PubMed Central

    Algauer, Andrea; Rivera, Stephanie; Faurote, Robert

    2015-01-01

    With increasing wait times in emergency departments (ED) across America, there is a need to streamline the inpatient admission process in order to decrease wait times and more important, to increase patient and employee satisfaction. One inpatient unit at New York-Presbyterian Weill Cornell Medical Center initiated a program to help expedite the inpatient admission process from the ED. The goal of the ED Bridge program is to ease the patient's transition from the ED to an inpatient unit by visiting the patient in the ED and introducing and setting expectations for the inpatient environment (i.e. telemetry alarms, roommates, hourly comfort rounds). Along with improving the patient experience, this program intends to improve the collaboration between ED nurses and inpatient nurses. With the continued support of our nurse management, hospital administrators and most important, our staff, this concept is aimed to increase patient satisfaction scores and subsequently employee satisfaction. PMID:28725813

  4. Integration of nursing assessment concepts into the medical entities dictionary using the LOINC semantic structure as a terminology model.

    PubMed

    Cieslowski, B J; Wajngurt, D; Cimino, J J; Bakken, S

    2001-01-01

    Recent investigations have tested the applicability of various terminology models for the representing nursing concepts including those related to nursing diagnoses, nursing interventions, and standardized nursing assessments as a prerequisite for building a reference terminology that supports the nursing domain. We used the semantic structure of Clinical LOINC (Logical Observations, Identifiers, Names, and Codes) as a reference terminology model to support the integration of standardized assessment terms from two nursing terminologies into the Medical Entities Dictionary (MED), the concept-oriented, metadata dictionary at New York Presbyterian Hospital. Although the LOINC semantic structure was used previously to represent laboratory terms in the MED, selected hierarchies and semantic slots required revisions in order to incorporate the nursing assessment concepts. This project was an initial step in integrating nursing assessment concepts into the MED in a manner consistent with evolving standards for reference terminology models. Moreover, the revisions provide the foundation for adding other types of standardized assessments to the MED.

  5. Integration of nursing assessment concepts into the medical entities dictionary using the LOINC semantic structure as a terminology model.

    PubMed Central

    Cieslowski, B. J.; Wajngurt, D.; Cimino, J. J.; Bakken, S.

    2001-01-01

    Recent investigations have tested the applicability of various terminology models for the representing nursing concepts including those related to nursing diagnoses, nursing interventions, and standardized nursing assessments as a prerequisite for building a reference terminology that supports the nursing domain. We used the semantic structure of Clinical LOINC (Logical Observations, Identifiers, Names, and Codes) as a reference terminology model to support the integration of standardized assessment terms from two nursing terminologies into the Medical Entities Dictionary (MED), the concept-oriented, metadata dictionary at New York Presbyterian Hospital. Although the LOINC semantic structure was used previously to represent laboratory terms in the MED, selected hierarchies and semantic slots required revisions in order to incorporate the nursing assessment concepts. This project was an initial step in integrating nursing assessment concepts into the MED in a manner consistent with evolving standards for reference terminology models. Moreover, the revisions provide the foundation for adding other types of standardized assessments to the MED. PMID:11825165

  6. Designing a Clinical Data Warehouse Architecture to Support Quality Improvement Initiatives

    PubMed Central

    Chelico, John D.; Wilcox, Adam B.; Vawdrey, David K.; Kuperman, Gilad J.

    2016-01-01

    Clinical data warehouses, initially directed towards clinical research or financial analyses, are evolving to support quality improvement efforts, and must now address the quality improvement life cycle. In addition, data that are needed for quality improvement often do not reside in a single database, requiring easier methods to query data across multiple disparate sources. We created a virtual data warehouse at NewYork Presbyterian Hospital that allowed us to bring together data from several source systems throughout the organization. We also created a framework to match the maturity of a data request in the quality improvement life cycle to proper tools needed for each request. As projects progress in the Define, Measure, Analyze, Improve, Control stages of quality improvement, there is a proper matching of resources the data needs at each step. We describe the analysis and design creating a robust model for applying clinical data warehousing to quality improvement. PMID:28269833

  7. STUDIES ON THE RELATIONSHIP OF STREPTOCOCCUS HEMOLYTICUS TO THE RHEUMATIC PROCESS

    PubMed Central

    Coburn, Alvin F.; Pauli, Ruth H.

    1932-01-01

    To determine the nature of the organisms associated with outbreaks of rheumatism at The Pelham Home, in a large number of individuals at the Presbyterian Hospital Nurses' Training School and among rheumatic subjects in New York City under continuous clinical observation, studies of the throat flora have been conducted. Hemolytic streptococcus in most instances appeared in the pharynx from 1 to 5 weeks before the onset of the rheumatic attack. These organisms have been investigated with the usual types of bacteriological tests and, in addition, have been classified serologically according to Lancefield's technique. The results have demonstrated that the organisms were not of a single type, but fell into six antigenic groups. The majority of the freshly isolated strains tested were strong toxin producers. The organisms producing the strongest toxin were cultures from the patients who developed extremely intense rheumatism. About 70 per cent of these toxins were neutralized by a monovalent streptococcus antiserum. PMID:19870090

  8. Arsonists in California and New York: a tentative look

    Treesearch

    William G. Bradshaw; Timothy G. Huff

    1985-01-01

    A nonrandom sample of 90 arsonists in California and New York was interviewed for the California Department of Forestry from 1977 to 1979. About two-thirds of them were in prison for arson, and the others were in mental hospitals. The 90 interviewees were mostly unmarried males ranging in age from 17 to 51 years. Survey results show that those who set their first arson...

  9. The Impact of Hospital Closures and Hospital and Population Characteristics on Increasing Emergency Department Volume: A Geographic Analysis.

    PubMed

    Lee, David C; Carr, Brendan G; Smith, Tony E; Tran, Van C; Polsky, Daniel; Branas, Charles C

    2015-12-01

    Emergency visits are rising nationally, whereas the number of emergency departments is shrinking. However, volume has not increased uniformly at all emergency departments. It is unclear what factors account for this variability in emergency volume growth rates. The objective of this study was to test the association of hospital and population characteristics and the effect of hospital closures with increases in emergency department volume. The study team analyzed emergency department volume at New York State hospitals from 2004 to 2010 using data from cost reports and administrative databases. Multivariate regression was used to evaluate characteristics associated with emergency volume growth. Spatial analytics and distances between hospitals were used in calculating the predicted impact of hospital closures on emergency department use. Among the 192 New York hospitals open from 2004 to 2010, the mean annual increase in emergency department visits was 2.7%, but the range was wide (-5.5% to 11.3%). Emergency volume increased nearly twice as fast at tertiary referral centers (4.8%) and nonurban hospitals (3.7% versus urban at 2.1%) after adjusting for other characteristics. The effect of hospital closures also strongly predicted variation in growth. Emergency volume is increasing faster at specific hospitals: tertiary referral centers, nonurban hospitals, and those near hospital closures. This study provides an understanding of how emergency volume varies among hospitals and predicts the effect of hospital closures in a statewide region. Understanding the impact of these factors on emergency department use is essential to ensure that these populations have access to critical emergency services.

  10. Treatment and Outcomes of Acute Myocardial Infarction Complicated by Shock After Public Reporting Policy Changes in New York.

    PubMed

    McCabe, James M; Waldo, Stephen W; Kennedy, Kevin F; Yeh, Robert W

    2016-09-01

    In 2006, New York began excluding patients with cardiogenic shock from the publicly reported percutaneous coronary intervention (PCI) risk-adjusted mortality analyses. To examine the effects of the New York shock-exclusion policy change on rates of revascularization and mortality for patients with acute myocardial infarction (AMI) complicated by cardiogenic shock. This study used several comprehensive statewide hospitalization databases to identify patients with AMI and shock from January 1, 2002, through December 31, 2012, in New York and a series of comparator states (Massachusetts, Michigan, and New Jersey from January 1, 2002, through December 31, 2012, and California from January 1, 2003, through December 31, 2011). Data analysis was performed from October 1, 2015, to March 15, 2016. A difference-in-differences approach was used to evaluate whether the likelihood of receiving PCI and surviving to discharge differed after the policy change in New York in 2006 compared with comparator states that did not enact such a change. Among 45 977 patients with AMI and cardiogenic shock (11 298 in New York), 21 974 (47.8%) underwent PCI. The mean (SD) age of the patients was 69.7 (13.2) years, and 18 139 (39.5%) were female. After adjusting for patient factors, patients in New York were significantly more likely to undergo PCI after the public reporting policy changes than they were previously (adjusted relative risk [aRR], 1.28; 95% CI, 1.19-1.37; P < .001) compared with a 9% increase in comparator states during the same period (aRR, 1.09; 95% CI, 1.05-1.13; P < .001; interaction P < .001). Nevertheless, rates of PCI remained lower in New York compared with comparator states throughout the study period. The adjusted risk of in-hospital death among patients in New York with AMI and shock decreased significantly faster after the policy change (aRR, 0.76; 95% CI, 0.72-0.81; P < .001) compared with comparator states (aRR, 0.91; 95% CI, 0

  11. A Spatial Analysis of Acute Myocardial Infarction Rates in New York State in Relation to Hospitals Along State Jurisdictional Borders.

    PubMed

    Stamm, Abigail J; Savadatti, Sanghamitra S; Kumar, Sanjaya; Hwang, Syni-An

    Patients experiencing acute myocardial infarction (AMI) are likely to visit the nearest hospital providing appropriate services since timely care is a critical determinant in the treatment and progression of AMI. We comparatively examined AMI rates in border and nonborder census tracts. The New York State (NYS) Environmental Public Health Tracking (EPHT) program, in conjunction with the Statewide Planning and Research Cooperative System, will work on developing memoranda of understanding with neighboring states to be able to more comprehensively access NYS residents' out-of-state health records. To determine whether AMI rates in the NYS border census tracts differ from AMI rates in nonborder census tracts as a preliminary exploration of the utilization of out-of-state care for acute health conditions by NYS border residents. We reviewed data on inpatient and emergency department visits in NYS with discharge dates from 2005 to 2014 retrospectively. We used the NYS EPHT tier 1 system database to locate hospitals. We geocoded all cases to NYS 2010 census tracts. We mapped differences between border and nonborder tracts and analyzed resulting spatial patterns. We computed tract-level AMI rates and differences between border and nonborder AMI rates. The age-adjusted AMI rates differed by 8.2 cases per 10 000 people (95% confidence interval, 6.94-12.60). Maps showed patterns of differences in AMI rates, especially along the NYS border with New England and other geographically closer out-of-state hospitals. AMI rates that were geographically closer to out-of-state hospitals were lower, suggesting that people residing in border census tracts are utilizing out-of-state care. Our study adds to literature on the geographical component of health care accessibility and utilization in the context of acute conditions such as AMI and lends impetus to access out-of-state health records to better understand health care facility access and utilization for NYS residents.

  12. Expanding Hospital Human Immunodeficiency Virus Testing in the Bronx, New York and Washington, District of Columbia: Results From the HPTN 065 Study.

    PubMed

    Branson, Bernard M; Chavez, Pollyanna R; Hanscom, Brett; Greene, Elizabeth; McKinstry, Laura; Buchacz, Kate; Beauchamp, Geetha; Gamble, Theresa; Zingman, Barry S; Telzak, Edward; Naab, Tammey; Fitzpatrick, Lisa; El-Sadr, Wafaa M

    2018-05-02

    Human immunodeficiency virus (HIV) testing is critical for both HIV treatment and prevention. Expanding testing in hospital settings can identify undiagnosed HIV infections. To evaluate the feasibility of universally offering HIV testing during emergency department (ED) visits and inpatient admissions, 9 hospitals in the Bronx, New York and 7 in Washington, District of Columbia (DC) undertook efforts to offer HIV testing routinely. Outcomes included the percentage of encounters with an HIV test, the change from year 1 to year 3, and the percentages of tests that were HIV-positive and new diagnoses. From 1 February 2011 to 31 January 2014, HIV tests were conducted during 6.5% of 1621016 ED visits and 13.0% of 361745 inpatient admissions in Bronx hospitals and 13.8% of 729172 ED visits and 22.0% of 150655 inpatient admissions in DC. From year 1 to year 3, testing was stable in the Bronx (ED visits: 6.6% to 6.9%; inpatient admissions: 13.0% to 13.6%), but increased in DC (ED visits: 11.9% to 15.8%; inpatient admissions: 19.0% to 23.9%). In the Bronx, 0.4% (408) of ED HIV tests were positive and 0.3% (277) were new diagnoses; 1.8% (828) of inpatient tests were positive and 0.5% (244) were new diagnoses. In DC, 0.6% (618) of ED tests were positive and 0.4% (404) were new diagnoses; 4.9% (1349) of inpatient tests were positive and 0.7% (189) were new diagnoses. Hospitals consistently identified previously undiagnosed HIV infections, but universal offer of HIV testing proved elusive.

  13. Malnutrition coding 101: financial impact and more.

    PubMed

    Giannopoulos, Georgia A; Merriman, Louise R; Rumsey, Alissa; Zwiebel, Douglas S

    2013-12-01

    Recent articles have addressed the characteristics associated with adult malnutrition as published by the Academy of Nutrition and Dietetics (the Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). This article describes a successful interdisciplinary program developed by the Department of Food and Nutrition at New York-Presbyterian Hospital to maintain and monitor clinical documentation, ensure accurate International Classification of Diseases 9th Edition (ICD-9) coding, and identify subsequent incremental revenue resulting from the early identification, documentation, and treatment of malnutrition in an adult inpatient population. The first step in the process requires registered dietitians to identify patients with malnutrition; then clear and specifically worded diagnostic statements that include the type and severity of malnutrition are documented in the medical record by the physician, nurse practitioner, or physician's assistant. This protocol allows the Heath Information Management/Coding department to accurately assign ICD-9 codes associated with protein-energy malnutrition. Once clinical coding is complete, a final diagnosis related group (DRG) is generated to ensure appropriate hospital reimbursement. Successful interdisciplinary programs such as this can drive optimal care and ensure appropriate reimbursement.

  14. Myocardial Revascularization in New York State: Variations in the PCI-to-CABG Ratio and Their Implications

    PubMed Central

    Ko, Wilson; Tranbaugh, Robert; Marmur, Jonathan D.; Supino, Phyllis G.; Borer, Jeffrey S.

    2012-01-01

    Background During the past 2 decades, percutaneous coronary intervention (PCI) has increased dramatically compared with coronary artery bypass grafting (CABG) for patients with coronary artery disease. However, although the evidence available to all practitioners is similar, the relative distribution of PCI and CABG appears to differ among hospitals and regions. Methods and Results We reviewed the published data from the mandatory New York State Department of Health annual cardiac procedure reports issued from 1994 through 2008 to define trends in PCI and CABG utilization in New York and to compare the PCI/CABG ratios in the metropolitan area to the remainder of the State. During this 15-year interval, the procedure volume changes for CABG, for all cardiac surgeries, for non-CABG cardiac surgeries, and for PCI for New York State were −40%, −20%, +17.5%, and +253%, respectively; for the Manhattan programs, the changes were similar as follows: −61%, −23%, +14%, and +284%. The average PCI/CABG ratio in New York State increased from 1.12 in 1994 to 5.14 in 2008; however, in Manhattan, the average PCI/CABG ratio increased from 1.19 to 8.04 (2008 range: 3.78 to 16.2). The 2008 PCI/CABG ratios of the Manhattan programs were higher than the ratios for New York City programs outside Manhattan, in Long Island, in the northern counties contiguous to New York City, and in the rest of New York State; their averages were 5.84, 5.38, 3.31, and 3.24, respectively. In Manhattan, a patient had a 56% greater chance of receiving PCI than CABG as compared with the rest of New York State; in one Manhattan program, the likelihood was 215% higher. Conclusions There are substantial regional and statewide differences in the utilization of PCI versus CABG among cardiac centers in New York, possibly related to patient characteristics, physician biases, and hospital culture. Understanding these disparities may facilitate the selection of the most appropriate, effective, and evidence

  15. COMMUNITY STRESS, DEMORALIZATION AND BODY MASS INDEX: EVIDENCE FOR SOCIAL SIGNAL TRANSDUCTION. (R827027)

    EPA Science Inventory

    Quantification of the relationship between community-level chronic stress from neighborhood conditions and individual morale has rarely been reported. In this work, pregnant women were recruited at the prenatal clinics of Harlem Hospital and Columbia Presbyterian Medical Cente...

  16. Racial Disparity in Surgical Complications in New York State

    PubMed Central

    Fiscella, Kevin; Franks, Peter; Meldrum, Sean; Barnett, Steven

    2005-01-01

    Objective: To examine the relationship between race and surgical complications. Summary Background Data: Blacks have been reported to experience higher rates of surgical complications than whites, but the reasons are not known. Methods: The effect of the black race on risk of any surgical complication (from the Agency for Healthcare Research and Quality's patient safety indicators) was examined using New York State (NYS) hospital discharge data from 1998 to 2000. Sequential, hierarchical analyses controlled for: 1) patient age and gender, 2) morbidity length of stay, 3) individual social factors, 4) hospital characteristics, and 5) ecologic factors (region of state, percent black and Medicaid annual discharges, and mean income of admitted patients). Results: Following adjustment for patient age and gender, blacks had 65% higher odds for a surgical complication. Further adjustment for comorbidity and length of stay (LOS) reduced the odds substantially to 1.18. Additional adjustment for American Hospital Association hospital characteristics essentially eliminated the risk. Final adjustment for hospital ecologic variables reduced the odds to 1.0. Conclusions: Higher rates of surgical complications among blacks than whites in NYS are primarily explained by differences in comorbidity LOS and the hospital where the surgery occurred. PMID:16041203

  17. Finding a larger newsletter audience. For New York Methodist, new approach is worthwhile.

    PubMed

    Botvin, J D

    2001-01-01

    New York Methodist Hospital met the challenges of intense competition in the Brooklyn, N.Y., market by switching its quarterly newsletter to an insert in the local editions of national publications. By so doing, it multiplied distribution tenfold, improved its credibility and freed up staff time for other projects.

  18. Surveying hospital network structure in New York State: how are they structured?

    PubMed

    Nauenberg, E; Brewer, C S

    2000-01-01

    We determine the most common network structures in New York state. The taxonomy employed uses three structural dimensions: integration, complexity, and risk-sharing between organizations. Based on a survey conducted in 1996, the most common type of network (26.4 percent) had medium levels of integration, medium or high levels of complexity, and some risk-sharing. Also common were networks with low levels of integration, low levels of complexity, and no risk-sharing (22.1 percent).

  19. Hartford Hospital surgeons share publicity with robot 'assistants.'.

    PubMed

    Botvin, Judith D

    2004-01-01

    Hartford Hospital, Hartford, Conn. finds some patients gravitate to Boston or New York City for high-tech procedures. Being the first Connecticut hospital with the daVinci Robotic Surgery System, it developed an advertising campaign emphasizing high-tech surgery with the human touch. Hartford also broadcast a robotic prostatectomy on its popular live webcast series.

  20. HCA Richmond Hospitals' new marketing strategy a winning plan.

    PubMed

    Rees, Tom

    2003-01-01

    HCA Richmond Hospitals, a five-hospital system in Richmond, Va., is positioning itself as a winner in a highly competitive, healthcare-saturated market since overhauling is marketing strategy a little over a year ago. The marketing strategy enables individual hospital to target their own unique constituencies. "Understanding the intricate marketing dynamics of hospital systems is today of critical importance and equal complexity," said Tony Bejamin, principal of Oxygen Advertising Inc., New York, the agency that remodeled HCA Richmond Hospitals' marketing strategy.

  1. Project Return and Babygram Hospital Outreach, 1993-94.

    ERIC Educational Resources Information Center

    Weiler, Jeanne

    Project Return, a dropout recovery program to assist pregnant and parenting teenagers and parents of elementary school children to return to school, was first implemented in 1989-90, and by 1993-94 had expanded to serve 19 sites in New York City. The Babygram Hospital Outreach program, an outgrowth of Project Return, operated in 12 hospitals and…

  2. History of Cardiothoracic Surgery at New York University.

    PubMed

    Smith, Deane E; Grossi, Eugene A; Galloway, Aubrey C

    2016-01-01

    This monograph outlines the rich history of cardiothoracic surgery at New York University (NYU), beginning with its origins at The Bellevue Hospital in the mid-1800's. Numerous early clinical accomplishments were significant, leading up to the arrival of Dr Frank Spencer in 1966. Under Dr Spencer's leadership, the department progressed with development of a culture of innovation, leadership and education that carries through today. The program encompasses three major hospitals and will soon graduate its 50 th class of trainees, many of whom have had outstanding careers and a major impact on the field of cardiothoracic surgery. This culture continues under the direction of our current chair, Dr Aubrey Galloway, whose vision has orchestrated and refined a new period of innovation and excellence. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Descriptive epidemiology of chronic hypertension, gestational hypertension, and preeclampsia in New York State, 1995-2004.

    PubMed

    Savitz, David A; Danilack, Valery A; Engel, Stephanie M; Elston, Beth; Lipkind, Heather S

    2014-05-01

    We examined social, demographic, and behavioral predictors of specific forms of hypertensive disorders in pregnancy in New York State. Administrative data on 2.3 million births over the period 1995-2004 were available for New York State, USA, with linkage to birth certificate data for New York City (964,071 births). ICD-9 hospital discharge diagnosis codes were used to assign hypertensive disorders hierarchically as chronic hypertension, chronic hypertension with superimposed preeclampsia, preeclampsia (eclampsia/severe or mild), or gestational hypertension. Sociodemographic and behavioral predictors of these outcomes were examined separately for upstate New York and New York City by calculating adjusted odds ratios. The most commonly diagnosed conditions were preeclampsia (2.57 % of upstate New York births, 3.68 % of New York City births) and gestational hypertension (2.46 % of upstate births, 1.42 % of New York City births). Chronic hypertension was much rarer. Relative to non-Hispanic Whites, Hispanics in New York City and Black women in all regions had markedly increased risks for all hypertensive disorders, whereas Asian women were at consistently decreased risk. Pregnancy-associated conditions decreased markedly with parity and modestly among smokers. A strong positive association was found between pre-pregnancy weight and risk of hypertensive disorders, with slightly weaker associations among Blacks and stronger associations among Asians. While patterns of chronic and pregnancy-induced hypertensive disorders differed, the predictors of gestational hypertension and both mild and severe preeclampsia were similar to one another. The increased risk for Black and some Hispanic women warrants clinical consideration, and the markedly increased risk with greater pre-pregnancy weight suggests an opportunity for primary prevention among all ethnic groups.

  4. 33 CFR 165.162 - Safety Zone: New York Super Boat Race, Hudson River, New York.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Safety Zone: New York Super Boat Race, Hudson River, New York. 165.162 Section 165.162 Navigation and Navigable Waters COAST GUARD... § 165.162 Safety Zone: New York Super Boat Race, Hudson River, New York. (a) Regulated area. The...

  5. The effects of price competition and reduced subsidies for uncompensated care on hospital mortality.

    PubMed

    Volpp, Kevin G M; Ketcham, Jonathan D; Epstein, Andrew J; Williams, Sankey V

    2005-08-01

    To determine whether hospital mortality rates changed in New Jersey after implementation of a law that changed hospital payment from a regulated system based on hospital cost to price competition with reduced subsidies for uncompensated care and whether changes in mortality rates were affected by hospital market conditions. State discharge data for New Jersey and New York from 1990 to 1996. Study Design. We used an interrupted time series design to compare risk-adjusted in-hospital mortality rates between states over time. We compared the effect sizes in markets with different levels of health maintenance organization penetration and hospital market concentration and tested the sensitivity of our results to different approaches to defining hospital markets. The study sample included all patients under age 65 admitted to New Jersey or New York hospitals with stroke, hip fracture, pneumonia, pulmonary embolism, congestive heart failure, hip fracture, or acute myocardial infarction (AMI). Mortality among patients in New Jersey improved less than in New York by 0.4 percentage points among the insured (p=.07) and 0.5 percentage points among the uninsured (p=.37). There was a relative increase in mortality for patients with AMI, congestive heart failure, and stroke, especially for uninsured patients with these conditions, but not for patients with the other four conditions we studied. Less competitive hospital markets were significantly associated with a relative decrease in mortality among insured patients. Market-based reforms may adversely affect mortality for some conditions but it appears the effects are not universal. Insured patients in less competitive markets fared better in the transition to price competition.

  6. Hospital diversification strategy.

    PubMed

    Eastaugh, Steven R

    2014-01-01

    To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger.

  7. 34. Photographic copy of historic drawing, "Naval Hospital and Battery ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    34. Photographic copy of historic drawing, "Naval Hospital and Battery at Portsmouth, VA.," ca. 1862. (From Paul F. Moteelay and T. Campbell-Copeland's The Soldier in Our Civil War: A Pictorial History of the Conflict, 1861-1865. New York: Stanley Bradley Publishing Company, 1890, vol. 1, p. 320.) - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

  8. Spatio-temporal Analysis for New York State SPARCS Data

    PubMed Central

    Chen, Xin; Wang, Yu; Schoenfeld, Elinor; Saltz, Mary; Saltz, Joel; Wang, Fusheng

    2017-01-01

    Increased accessibility of health data provides unique opportunities to discover spatio-temporal patterns of diseases. For example, New York State SPARCS (Statewide Planning and Research Cooperative System) data collects patient level detail on patient demographics, diagnoses, services, and charges for each hospital inpatient stay and outpatient visit. Such data also provides home addresses for each patient. This paper presents our preliminary work on spatial, temporal, and spatial-temporal analysis of disease patterns for New York State using SPARCS data. We analyzed spatial distribution patterns of typical diseases at ZIP code level. We performed temporal analysis of common diseases based on 12 years’ historical data. We then compared the spatial variations for diseases with different levels of clustering tendency, and studied the evolution history of such spatial patterns. Case studies based on asthma demonstrated that the discovered spatial clusters are consistent with prior studies. We visualized our spatial-temporal patterns as animations through videos. PMID:28815148

  9. 77 FR 42507 - Notice of Inventory Completion: New York University College of Dentistry, New York, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-19

    ... Inventory Completion: New York University College of Dentistry, New York, NY AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The New York University College of Dentistry has completed an inventory... the New York University College of Dentistry. Disposition of the human remains to the Indian tribes...

  10. 77 FR 42513 - Notice of Inventory Completion: New York University College of Dentistry, New York, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-19

    ... Inventory Completion: New York University College of Dentistry, New York, NY AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The New York University College of Dentistry has completed an inventory... the New York University College of Dentistry. Disposition of the human remains to the Indian tribes...

  11. 77 FR 42508 - Notice of Inventory Completion: New York University College of Dentistry, New York, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-19

    ... Inventory Completion: New York University College of Dentistry, New York, NY AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The New York University College of Dentistry has completed an inventory... the New York University College of Dentistry. Repatriation of the human remains to the Indian tribes...

  12. Medicare managed care plan performance: a comparison across hospitalization types.

    PubMed

    Basu, Jayasree; Mobley, Lee Rivers

    2012-01-01

    The study evaluates the performance of Medicare managed care (Medicare Advantage [MA]) Plans in comparison to Medicare fee-for-service (FFS) Plans in three states with historically high Medicare managed care penetration (New York, California, Florida), in terms of lowering the risks of preventable or ambulatory care sensitive conditions (ACSC) hospital admissions and providing increased referrals for admissions for specialty procedures. Using 2004 hospital discharge files from the Healthcare Cost and Utilization Project (HCUP-SID) of the Agency for Healthcare Research and Quality, ACSC admissions are compared with 'marker' admissions and 'referral-sensitive' admissions, using a multinomial logistic regression approach. The year 2004 represents a strategic time to test the impact of MA on preventable hospitalizations, because the HMOs dominated the market composition in that time period. MA enrollees in California experienced 22% lower relative risk (RRR= 0.78, p<0.01), those in Florida experienced 16% lower relative risk (RRR= 0.84, p<0.01), while those in New York experienced 9% lower relative risk (RRR=0.91, p<0.01) of preventable (versus marker) admissions compared to their FFS counterparts. MA enrollees in New York experienced 37% higher relative risk (RRR=1.37, p<0.01) and those in Florida had 41% higher relative risk (RRR=1.41, p<0.01)-while MA enrollees in California had 13% lower relative risk (RRR=0.87, p<0.01)-of referral-sensitive (versus marker) admissions compared to their FFS counterparts. While MA plans were associated with reductions in preventable hospitalizations in all three states, the effects on referral-sensitive admissions varied, with California experiencing lower relative risk of referral-sensitive admissions for MA plan enrollees. The lower relative risk of preventable admissions for MA plan enrollees in New York and Florida became more pronounced after accounting for selection bias.

  13. STS-36 night Earth observation of New York City, New York

    NASA Image and Video Library

    1990-03-03

    STS-36 Earth observation shows New York City, New York at night lit up along the Eastern seaboard of the United States and the Atlantic Ocean. The city lights designate the densely populated central city and the major highways surrounding it.

  14. 75 FR 33329 - Notice of Inventory Completion: New York University College of Dentistry, New York, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-11

    ... University College of Dentistry, New York, NY AGENCY: National Park Service, Interior. ACTION: Notice. Notice... the New York University College of Dentistry, New York, NY. The human remains were removed from.... A detailed assessment of the human remains was made by the New York University College of Dentistry...

  15. Impact of residential displacement on healthcare access and mental health among original residents of gentrifying neighborhoods in New York City

    PubMed Central

    Walters, Sarah; Culp, Gretchen; Huynh, Mary; Gould, L. Hannah

    2017-01-01

    Objectives As gentrification continues in New York City as well as other urban areas, residents of lower socioeconomic status maybe at higher risk for residential displacement. Yet, there have been few quantitative assessments of the health impacts of displacement. The objective of this paper is to assess the association between displacement and healthcare access and mental health among the original residents of gentrifying neighborhoods in New York City. Methods We used 2 data sources: 1) 2005–2014 American Community Surveys to identify gentrifying neighborhoods in New York City, and 2) 2006–2014 Statewide Planning and Research Cooperative System. Our cohort included 12,882 residents of gentrifying neighborhoods in 2006 who had records of emergency department visits or hospitalization at least once every 2 years in 2006–2014. Rates of emergency department visits and hospitalizations post-baseline were compared between residents who were displaced and those who remained. Results During 2006–2014, 23% were displaced. Compared with those who remained, displaced residents were more likely to make emergency department visits and experience hospitalizations, mainly due to mental health (Rate Ratio = 1.8, 95% confidence interval = 1.5, 2.2), after controlling for baseline demographics, health status, healthcare utilization, residential movement, and the neighborhood of residence in 2006. Conclusions These findings suggest negative impacts of displacement on healthcare access and mental health, particularly among adults living in urban areas and with a history of frequent emergency department visits or hospitalizations. PMID:29272306

  16. Impact of residential displacement on healthcare access and mental health among original residents of gentrifying neighborhoods in New York City.

    PubMed

    Lim, Sungwoo; Chan, Pui Ying; Walters, Sarah; Culp, Gretchen; Huynh, Mary; Gould, L Hannah

    2017-01-01

    As gentrification continues in New York City as well as other urban areas, residents of lower socioeconomic status maybe at higher risk for residential displacement. Yet, there have been few quantitative assessments of the health impacts of displacement. The objective of this paper is to assess the association between displacement and healthcare access and mental health among the original residents of gentrifying neighborhoods in New York City. We used 2 data sources: 1) 2005-2014 American Community Surveys to identify gentrifying neighborhoods in New York City, and 2) 2006-2014 Statewide Planning and Research Cooperative System. Our cohort included 12,882 residents of gentrifying neighborhoods in 2006 who had records of emergency department visits or hospitalization at least once every 2 years in 2006-2014. Rates of emergency department visits and hospitalizations post-baseline were compared between residents who were displaced and those who remained. During 2006-2014, 23% were displaced. Compared with those who remained, displaced residents were more likely to make emergency department visits and experience hospitalizations, mainly due to mental health (Rate Ratio = 1.8, 95% confidence interval = 1.5, 2.2), after controlling for baseline demographics, health status, healthcare utilization, residential movement, and the neighborhood of residence in 2006. These findings suggest negative impacts of displacement on healthcare access and mental health, particularly among adults living in urban areas and with a history of frequent emergency department visits or hospitalizations.

  17. General Surgery Programs in Small Rural New York State Hospitals: A Pilot Survey of Hospital Administrators

    ERIC Educational Resources Information Center

    Zuckerman, Randall; Doty, Brit; Gold, Michael; Bordley, James; Dietz, Patrick; Jenkins, Paul; Heneghan, Steven

    2006-01-01

    Context: Hospitals play a central role in small rural communities and are frequently one of the major contributors to the local economy. Surgical services often account for a substantial proportion of hospital revenues. The current shortage of general surgeons practicing in rural communities may further threaten the financial viability of rural…

  18. [Hospital governance and the structure of German hospital supervisory boards].

    PubMed

    Kuntz, L; Pulm, J; Wittland, M

    2014-06-01

    When thinking about corporate governance frequently the supervisory board comes to mind. The aim of this study is to investigate the relationship between the participation of single professions in the supervisory board and hospital financial performance. Based on governance codes, relevant professions that should be part of the supervisory board are identified. With the help of a multiple regression, the relationship between the fractions of these professions in the supervisory board and the return on assets in the year 2009 is examined. The sample consists of 182 hospitals. The study shows that participation of physicians in the supervisory board is related to a higher return on assets. Furthermore, the association between the fractions of nurses and politicians and hospitals financial performance is ­negative. The composition of the supervisory board has a significant effect on hospital performance; it is an important issue for hospital owners. The present study identifies only one positive relationship between the involvement of physicians and financial performance. Other professions could be relevant in achieving other objectives. Further studies are necessary to analyse the effects on other dimensions of hospital performance, e. g., on quality. © Georg Thieme Verlag KG Stuttgart · New York.

  19. New York City, New York Municipal Forest Resource Analysis

    Treesearch

    P.J. Peper; E.G. McPherson; J.R. Simpson; S.L. Gardner; K.E. Vargas; Q. Xiao

    2007-01-01

    New York City, the largest city in the United States and one of the world’s major global cities, main-tains trees as an integral component of the urban infrastructure (Figure 1). Since 1995, over 120,000 trees have been planted along the streets of the city’s five boroughs. Over 592,000 street trees are managed by the New York City Department of Parks & Recreation...

  20. Practical experience with the maintenance and auditing of a large medical ontology.

    PubMed

    Baorto, David; Li, Li; Cimino, James J

    2009-06-01

    The Medical Entities Dictionary (MED) has served as a unified terminology at New York Presbyterian Hospital and Columbia University for more than 20 years. It was initially created to allow the clinical data from the disparate information systems (e.g., radiology, pharmacy, and multiple laboratories, etc.) to be uniquely codified for storage in a single data repository, and functions as a real time terminology server for clinical applications and decision support tools. Being conceived as a knowledge base, the MED incorporates relationships among local terms, between local terms and external standards, and additional knowledge about terms in a semantic network structure. Over the past two decades, we have sought to develop methods to maintain, audit and improve the content of the MED, such that it remains true to its original design goals. This has resulted in a complex, multi-faceted process, with both manual and automated components. In this paper, we describe this process, with examples of its effectiveness. We believe that our process provides lessons for others who seek to maintain complex, concept-oriented controlled terminologies.

  1. Practical Experience with the Maintenance and Auditing of a Large Medical Ontology

    PubMed Central

    Baorto, David; Li, Li; Cimino, James J.

    2012-01-01

    The Medical Entities Dictionary (MED) has served as a unified terminology at New York Presbyterian Hospital and Columbia University for more than 20 years. It was initially created to allow the clinical data from the disparate information systems (e.g., radiology, pharmacy, and multiple laboratories, etc) to be uniquely codified for storage in a single data repository, and functions as a real time terminology server for clinical applications and decision support tools. Being conceived as a knowledge base, the MED incorporates relationships among local terms, between local terms and external standards, and additional knowledge about terms in a semantic network structure. Over the past two decades, we have sought to develop methods to maintain, audit and improve the content of the MED, such that it remains true to its original design goals. This has resulted in a complex, multi-faceted process, with both manual and automated components. In this paper, we describe this process, with examples of its effectiveness. We believe that our process provides lessons for others who seek to maintain complex, concept-oriented controlled terminologies. PMID:19285569

  2. 77 FR 42510 - Notice of Inventory Completion: New York University College of Dentistry, New York, NY; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-19

    ... Inventory Completion: New York University College of Dentistry, New York, NY; Correction AGENCY: National... of human remains under the control of the New York University College of Dentistry, New York, NY. The... Dentistry professional staff in consultation with representatives of the Delaware Nation of Oklahoma...

  3. 78 FR 29364 - Independent Power Producers of New York, Inc. v. New York Independent System Operator, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-20

    ... Power Producers of New York, Inc. v. New York Independent System Operator, Inc. Notice of Complaint Take notice that on May 10, 2013, Independent Power Producers of New York, Inc. (IPPNY or Complainant) filed a complaint against New York Independent System Operator, Inc. (NYISO or Respondent), pursuant to [[Page 29365...

  4. Integration in New York City Schools

    ERIC Educational Resources Information Center

    Anker, Irving

    1975-01-01

    The Chancellor of the New York City Board of Education discusses, in his testimony before a May 1974 public hearing of the New York City Commission on Human Rights why the goal of integration in New York City, as in other inner city areas throughout the country, remained so elusive, noting that 66 percent of public school children in New York City…

  5. The World Trade Center attack. Observations from New York's Bellevue Hospital.

    PubMed

    Roccaforte, J D

    2001-12-01

    This report describes selected aspects of the response by Bellevue Hospital Center to the World Trade Center attack of 11 September 2001. The hospital is 2.5 miles (4 km) from the site of the attack. These first-hand observations and this analysis may aid in future preparations. Key issues described relate to communication, organization, injuries treated, staffing, and logistics.

  6. The World Trade Center Attack: Observations from New York's Bellevue Hospital

    PubMed Central

    Roccaforte, J David

    2001-01-01

    This report describes selected aspects of the response by Bellevue Hospital Center to the World Trade Center attack of 11 September 2001. The hospital is 2.5 miles (4 km) from the site of the attack. These first-hand observations and this analysis may aid in future preparations. Key issues described relate to communication, organization, injuries treated, staffing, and logistics. PMID:11737913

  7. Patient turnover and nursing employment in Massachusetts hospitals before and after health insurance reform: implications for the Patient Protection and Affordable Care Act.

    PubMed

    Shindul-Rothschild, Judith; Gregas, Matt

    2013-01-01

    The Affordable Care Act is modeled after Massachusetts insurance reforms enacted in 2006. A linear mixed effect model examined trends in patient turnover and nurse employment in Massachusetts, New York, and California nonfederal hospitals from 2000 to 2011. The linear mixed effect analysis found that the rate of increase in hospital admissions was significantly higher in Massachusetts hospitals (p<.001) than that in California and New York (p=.007). The rate of change in registered nurses full-time equivalent hours per patient day was significantly less (p=.02) in Massachusetts than that in California and was not different from zero. The rate of change in admissions to registered nurses full-time equivalent hours per patient day was significantly greater in Massachusetts than California (p=.001) and New York (p<.01). Nurse staffing remained flat in Massachusetts, despite a significant increase in hospital admissions. The implications of the findings for nurse employment and hospital utilization following the implementation of national health insurance reform are discussed.

  8. Hospital strategic planning diversity integration based organizational type and CEO tenure.

    PubMed

    Newhouse, John J

    2007-01-01

    The author investigated the strategic planning processes used by five different hospital types to integrate diversity practices into their operations. Chief executive officers from Delaware, New Jersey, New York, and Pennsylvania were surveyed to examine how their hospitals used strategic planning in this process. The central research question was: Does this process vary on the basis of hospital type? The findings indicated that some differences do exist by hospital type, as well as the length of tenure for CEOs in their positions.

  9. Voting pattern of mental patients in a community state hospital.

    PubMed

    Klein, M M; Grossman, S A

    1967-06-01

    The voting pattern of mental patients in a community-based state hospital was studied. Patients were polled on the New York City mayoralty race. A comparison to the vote of the general population revealed that the hospital sample vote resembled most closely the election results of the hospital district. The results highlight the advantage of community-centered mental health facilities, which undertake the treatment and rehabilitation of mental patients under conditions that maintain ties with family and community.

  10. 75 FR 36110 - Notice of Inventory Completion: New York University College of Dentistry, New York, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-24

    ... University College of Dentistry, New York, NY AGENCY: National Park Service, Interior. ACTION: Notice. Notice... the New York University College of Dentistry, New York, NY. The human remains were removed from... College of Dentistry professional staff in consultation with representatives of the Alabama-Quassarte...

  11. Birth Outcomes across Three Rural-Urban Typologies in the Finger Lakes Region of New York

    ERIC Educational Resources Information Center

    Strutz, Kelly L.; Dozier, Ann M.; van Wijngaarden, Edwin; Glantz, J. Christopher

    2012-01-01

    Purpose: The study is a descriptive, population-based analysis of birth outcomes in the New York State Finger Lakes region designed to determine whether perinatal outcomes differed across 3 rural typologies. Methods: Hospital birth data for the Finger Lakes region from 2006 to 2007 were used to identify births classified as low birthweight (LBW),…

  12. 75 FR 52021 - Notice of Inventory Completion: New York University College of Dentistry, New York, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-24

    ... University College of Dentistry, New York, NY AGENCY: National Park Service, Interior. ACTION: Notice. Notice... University College of Dentistry, New York, NY. The human remains were removed from an unknown location. This... the human remains was made by New York University College of Dentistry professional staff in...

  13. 75 FR 33329 - Notice of Inventory Completion: New York University College of Dentistry, New York, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-11

    ... University College of Dentistry, New York, NY AGENCY: National Park Service, Interior. ACTION: Notice. Notice... and control of the New York University College of Dentistry, New York, NY. The human remains were... College of Dentistry professional staff in consultation with representatives of the Tuscarora Nation of...

  14. 75 FR 52021 - Notice of Inventory Completion: New York University College of Dentistry, New York, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-24

    ... University College of Dentistry, New York, NY AGENCY: National Park Service, Interior. ACTION: Notice. Notice... University College of Dentistry, New York, NY. The human remains were removed from Port Clarence, Nome County... the human remains was made by New York University College of Dentistry professional staff in...

  15. [Controlling and operation management in hospitals].

    PubMed

    Vagts, Dierk A

    2010-03-01

    The economical pressure on the health system and especially on hospitals is growing rapidly. Hence, economical knowledge for people in medical executive positions becomes imperative. In advanced and forward-looking hospitals controlling is gaining more and more weight, because it takes over a coordinative responsibility. Ideally controlling is navigating the teamwork of managers (CEOs) and medical executives by weighing medical necessities and economical framework. Controlling is contributing to evaluate an optimal efficiency of a hospital in a highly competitive surrounding by providing medical and economical data on a regular basis. A close, open-minded and trusting cooperation between all people, who are involved, is imperative. Hence, controlling in the proper meaning of the word can not flourish in dominant and hierarchic hospital structures. Georg Thieme Verlag Stuttgart * New York.

  16. The Hospital for Special Surgery 1972–1989; Philip D. Wilson, Jr., Eighth Surgeon-in-Chief

    PubMed Central

    2010-01-01

    After nearly a decade as the seventh Surgeon-in-Chief (1963–1972) of The Hospital for Special Surgery (HSS), Robert Lee Patterson, Jr., MD (1907–1994) retired, having repaired adverse relations between HSS and the New York Hospital-Cornell Medical Center. Patterson, who had first joined the staff of The Hospital for the Ruptured and Crippled in 1936 as a Visiting Surgeon, was able to accomplish this very challenging task mainly through his close relationship with Preston Wade, MD (1901–1982), a general surgeon who had served with Patterson as Co-Chief of the combined New York Hospital-HSS Fracture service. The Board of Trustees of the New York Society for the Relief of the Ruptured and Crippled appointed Philip D. Wilson, Jr. MD, as the eighth Surgeon-in-Chief of The Hospital for Special Surgery. He assumed that office on July 1, 1972. Wilson, who had joined the staff as an Orthopaedic Surgeon to the Out-Patient Department in 1951, had trained as an orthopaedic resident at HSS from 1948 to 1950 and in 1951, finished his residency at the University of California Hospital Medical Center, San Francisco. During his 17 years as Surgeon-in-Chief, he led the hospital into the advanced field of implant research and development and building a world-class center for patient care. Additionally, many other orthopaedic services such as Sports Medicine, Scoliosis and Metabolic Bone Diseases became the leaders in their fields. Supporting Departments of Rheumatology, Anesthesia and others were likewise recognized foremost in the country. PMID:21886524

  17. Comparative analysis of health system performance in Montreal and New York: the importance of context for interpreting indicators.

    PubMed

    Gusmano, Michael K; Strumpf, Erin; Fiset-Laniel, Julie; Weisz, Daniel; Rodwin, Victor G

    2018-06-19

    Although eliminating financial barriers to care is a necessary condition for improving access to health services, it is not sufficient. Given the contrasting health systems with regard to financing and organization of health insurance in the United States and Canada, there is a long history of comparing these countries. We extend the empirical studies on the Canadian and US health systems by comparing access to ambulatory care as measured by hospitalization rates for ambulatory care sensitive conditions (ACSC) in Montreal and New York City. We find that, in New York, ACSC rates were more than twice as high (12.6 per 1000 population) as in Montreal (4.8 per 1000 population). After controlling for age, sex, and number of diagnoses, significant differences in ACSC rates are present in both cities, but are more pronounced in New York. Our findings are consistent with the hypothesis that universal, first-dollar health insurance coverage has contributed to lower ACSC rates in Montreal than New York. However, Montreal's surprisingly low ACSC rate calls for further research.

  18. Using Claims Data to Generate Clinical Flags Predicting Short-term Risk of Continued Psychiatric Hospitalizations

    PubMed Central

    Stein, Bradley D.; Pangilinan, Maria; Sorbero, Mark J; Marcus, Sue; Donahue, Sheila; Xu, Yan; Smith, Thomas E; Essock, Susan M

    2014-01-01

    Objective As health information technology advances, efforts to use administrative data to inform real-time treatment planning for individuals are increasing, despite few empirical studies demonstrating that such administrative data predict subsequent clinical events. Medicaid claims for individuals with frequent psychiatric hospitalizations were examined to test how well patterns of service use predict subsequent high short-term risk of continued psychiatric hospitalizations. Methods Medicaid claims files from New York and Pennsylvania were used to identify Medicaid recipients aged 18-64 with two or more inpatient psychiatric admissions during a target year ending March 31, 2009. Definitions from a quality-improvement initiative were used to identify patterns of inpatient and outpatient service use and prescription fills suggestive of clinical concerns. Generalized estimating equations and Markov models were applied to examine claims through March, 2011, to see what patterns of service use were sufficiently predictive of additional hospitalizations to be clinically useful. Results 11,801 unique individuals in New York and 1,859 in Pennsylvania identified met the cohort definition. In both Pennsylvania and New York, multiple recent hospitalizations, but not failure to use outpatient services or failure to fill medication prescriptions, were significant predictors of high risk of continued frequent hospitalizations, with odds ratios greater than 4.0. Conclusions Administrative data can be used to identify individuals at high risk of continued frequent hospitalizations. Such information could be used by payers and system administrators to authorize special services (e.g., mobile outreach) for such individuals as part of efforts to promote service engagement and prevent rapid rehospitalizations. PMID:25022360

  19. Severe Maternal Morbidity Among Hispanic Women in New York City: Investigation of Health Disparities.

    PubMed

    Howell, Elizabeth A; Egorova, Natalia N; Janevic, Teresa; Balbierz, Amy; Zeitlin, Jennifer; Hebert, Paul L

    2017-02-01

    To investigate differences in severe maternal morbidity between Hispanic mothers and three major Hispanic subgroups compared with non-Hispanic white mothers and the extent to which differences in delivery hospitals may contribute to excess morbidity among Hispanic mothers. We conducted a population-based cross-sectional study using linked 2011-2013 New York City discharge and birth certificate data sets (n=353,773). Rates of severe maternal morbidity were calculated using a published algorithm based on diagnosis and procedure codes. Mixed-effects logistic regression with a random hospital-specific intercept was used to generate risk-standardized severe maternal morbidity rates for each hospital taking into consideration patient sociodemographic characteristics and comorbidities. Differences in the distribution of Hispanic and non-Hispanic white deliveries were assessed among these hospitals in relation to their risk-adjusted morbidity. Sensitivity analyses were conducted after excluding isolated blood transfusion from the morbidity composite. Severe maternal morbidity occurred in 4,541 deliveries and was higher among Hispanic than non-Hispanic white women (2.7% compared with 1.5%, P<.001); this rate was 2.9% among those who were Puerto Rican, 2.7% among those who were foreign-born Dominican, and 3.3% among those who were foreign-born Mexican. After adjustment for patient characteristics, the risk remained elevated for Hispanic women (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.22-1.66) and for all three subgroups compared with non-Hispanic white women (P<.001). Risk for Hispanic women was attenuated in sensitivity analyses (OR 1.17, 95% CI 1.02-1.33). Risk-standardized morbidity across hospitals varied sixfold. We estimate that Hispanic-non-Hispanic white differences in delivery location may contribute up to 37% of the ethnic disparity in severe maternal morbidity rates in New York City hospitals. Hispanic compared with non-Hispanic white mothers are more

  20. Impact of a New York City Supportive Housing Program on Housing Stability and Preventable Health Care among Homeless Families.

    PubMed

    Lim, Sungwoo; Singh, Tejinder P; Hall, Gerod; Walters, Sarah; Gould, L Hannah

    2018-03-12

    To assess the impact of a New York City supportive housing program on housing stability and preventable emergency department (ED) visits/hospitalizations among heads of homeless families with mental and physical health conditions or substance use disorders. Multiple administrative data from New York City and New York State for 966 heads of families eligible for the program during 2007-12. We captured housing events and health care service utilization during 2 years prior to the first program eligibility date (baseline) and 2 years postbaseline. We performed sequence analysis to measure housing stability and compared housing stability and preventable ED visits and hospitalizations between program participants (treatment group) and eligible applicants not placed in the program (comparison group) via marginal structural modeling. We matched electronically collected data. Eighty-seven percent of supportive housing tenants experienced housing stability in 2 years postbaseline. Compared with unstably housed heads of families in the comparison group, those in the treatment group were 0.60 times as likely to make preventable ED visits postbaseline (95% CI = 0.38, 0.96). Supportive housing placement was associated with improved housing stability and reduced preventable health care visits among homeless families. © Health Research and Educational Trust.

  1. Sexual Risk Factors for HIV and Violence among Puerto Rican Women in New York City

    ERIC Educational Resources Information Center

    Moreno, Claudia L.; Morrill, Allison C.; El-Bassel, Nabila

    2011-01-01

    The authors examined sexual factors for HIV risk in 1,003 women of Puerto Rican heritage who attended a community-based New York City hospital clinic. Participants' ages ranged from 18 to 73 years. Half were born in the continental United States, and half were born in the Commonwealth of Puerto Rico. All were sexually active within the past 90…

  2. Abstracts of State Legislated Hospital Cost-Containment Programs

    PubMed Central

    Esposito, Alfonso; Hupfer, Michael; Mason, Cynthia; Rogler, Diane

    1982-01-01

    This report summarizes State legislated efforts to control rising hospital costs and the status of these efforts in May 1982. The abstract for each of 17 State programs summarizes key legislative features and operating aspects. The States included in this report are: Arizona, California, Connecticut, Florida, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Rhode Island, Virginia, Washington, West Virginia, and Wisconsin. The abstracts focus on programs requiring the disclosure, review, or legislation of hospital rates and budgets. PMID:10309910

  3. Bilingual Education in New York City.

    ERIC Educational Resources Information Center

    Jenkins, Mary

    This report attempts to place in perspective the position of bilingual education in New York City. It is divided into the following sections: (1) Bilingual Education--A Historical Perspective, (2) The Puerto Rican Child in the New York City School System, (3) Bilingual Education in the New York City School System, (4) Funding for Bilingual…

  4. Unintentional drownings among New York State residents, 1988-1994.

    PubMed Central

    Browne, Marilyn L.; Lewis-Michl, Elizabeth L.; Stark, Alice D.

    2003-01-01

    OBJECTIVE: This study examines situations in which drownings occur (environmental risk factors) and the victims' personal risk factors (age, gender, use of personal flotation device, medical condition, alcohol or drug use) to provide guidance for future drowning prevention efforts. METHODS: The authors investigated 883 non-bathtub drownings among New York State residents for the years 1988 to 1994 using medical examiner, coroner, police, and/or hospital records in addition to death certificate data. RESULTS: Males, children ages 0-4 years, and African American males ages 5-14 years residing in New York State outside New York City experienced the highest rates of drowning. The majority of drownings occurred in a natural body of water for all age groups, with the exception of children ages 0-4 years. Most drownings among children ages 0-4 years occurred in residential swimming pools. The child usually gained access to the pool via inadequate fencing, an open or ineffective gate, or a ladder (to an above-ground pool) left in the "down" position. Less than 10% of victims of watercraft-related drownings were wearing personal flotation devices. Blood alcohol concentration (BAC) tests were positive for 44% of 250 persons 15 years of age and older for whom valid toxicology results were provided; 30% had BACs of 100 mg/dl or more. CONCLUSIONS: Suggested prevention efforts include stricter enforcement of fencing requirements for residential swimming pools and drowning prevention education stressing personal flotation device use while boating and the danger of mixing alcohol and water-related activities. PMID:12941857

  5. 77 FR 40518 - Swim Events in the Captain of the Port New York Zone; Hudson River, East River, Upper New York...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-10

    ... 1625-AA00 Swim Events in the Captain of the Port New York Zone; Hudson River, East River, Upper New York Bay, Lower New York Bay; New York, NY ACTION: Final rule. SUMMARY: The Coast Guard is establishing seven temporary safety zones for swim events within the Captain of the Port (COTP) New York Zone. These...

  6. Association of Indoor Smoke-Free Air Laws with Hospital Admissions for Acute Myocardial Infarction and Stroke in Three States

    PubMed Central

    Loomis, Brett R.; Juster, Harlan R.

    2012-01-01

    Objective. To examine whether comprehensive smoke-free air laws enacted in Florida, New York, and Oregon are associated with reductions in hospital admissions for acute myocardial infarction (AMI) and stroke. Methods. Analyzed trends in county-level, age-adjusted, hospital admission rates for AMI and stroke from 1990 to 2006 (quarterly) for Florida, 1995 to 2006 (monthly) for New York, and 1998 to 2006 (monthly) for Oregon to identify any association between admission rates and passage of comprehensive smoke-free air laws. Interrupted time series analysis was used to adjust for the effects of preexisting moderate local-level laws, seasonal variation in hospital admissions, differences across counties, and a secular time trend. Results. More than 3 years after passage of statewide comprehensive smoke-free air laws, rates of hospitalization for AMI were reduced by 18.4% (95% CI: 8.8–28.0%) in Florida and 15.5% (95% CI: 11.0–20.1%) in New York. Rates of hospitalization for stroke were reduced by 18.1% (95% CI: 9.3–30.0%) in Florida. The few local comprehensive laws in Oregon were not associated with reductions in AMI or stroke statewide. Conclusion. Comprehensive smoke-free air laws are an effective policy tool for reducing the burden of AMI and stroke. PMID:22778759

  7. Association of indoor smoke-free air laws with hospital admissions for acute myocardial infarction and stroke in three states.

    PubMed

    Loomis, Brett R; Juster, Harlan R

    2012-01-01

    To examine whether comprehensive smoke-free air laws enacted in Florida, New York, and Oregon are associated with reductions in hospital admissions for acute myocardial infarction (AMI) and stroke. Analyzed trends in county-level, age-adjusted, hospital admission rates for AMI and stroke from 1990 to 2006 (quarterly) for Florida, 1995 to 2006 (monthly) for New York, and 1998 to 2006 (monthly) for Oregon to identify any association between admission rates and passage of comprehensive smoke-free air laws. Interrupted time series analysis was used to adjust for the effects of preexisting moderate local-level laws, seasonal variation in hospital admissions, differences across counties, and a secular time trend. More than 3 years after passage of statewide comprehensive smoke-free air laws, rates of hospitalization for AMI were reduced by 18.4% (95% CI: 8.8-28.0%) in Florida and 15.5% (95% CI: 11.0-20.1%) in New York. Rates of hospitalization for stroke were reduced by 18.1% (95% CI: 9.3-30.0%) in Florida. The few local comprehensive laws in Oregon were not associated with reductions in AMI or stroke statewide. Comprehensive smoke-free air laws are an effective policy tool for reducing the burden of AMI and stroke.

  8. Using Telemedicine to Address Crowding in the ED.

    PubMed

    Guss, Benjamin; Mishkin, David; Sharma, Rahul

    2016-11-01

    Some health systems are piloting telemedicine solutions in the ED to address crowding and decrease patient wait times. One new program, implemented at the Lisa Perry Emergency Center at New York Presbyterian (NYP) Weill Cornell Medical Center in New York, involves offering low-acuity patients the option of visiting an off-site physician via telemedicine hookup. Administrators note that the approach can get patients in and out of the ED within 30 minutes, and patients have thus far been highly satisfied with the approach. However, an earlier telemedicine program piloted at the University of San Diego Health System’s (UCSD) Hillcrest Hospital in 2013 got bogged down due to administrative and insurance reimbursement hurdles, although the approach showed enough promise that there is interest in restarting the program. In the NYP program, patients are identified as appropriate candidates for the program at triage. They can opt to be seen remotely or through traditional means in the ED’s fast-track section. Administrators note that patients with complex problems requiring extensive workups are not suitable for the telemedicine approach. The most challenging aspect of implementing a successful telemedicine program in the ED is getting the workflows right, according to administrators. An earlier ED-based telemedicine program piloted at UCSD ran into difficulties because the model required the involvement of two physicians, and some insurers did not want to pay for the telemedicine visits. However, patients were receptive.

  9. Temporal Trends in Anesthesia-related Adverse Events in Cesarean Deliveries, New York State, 2003-2012.

    PubMed

    Guglielminotti, Jean; Wong, Cynthia A; Landau, Ruth; Li, Guohua

    2015-11-01

    Cesarean delivery (CD) is associated with significantly increased risks of anesthesia-related adverse events (ARAEs) and nonanesthetic perioperative morbidity compared with vaginal delivery. Temporal trends in these adverse outcomes remain unknown despite efforts to improve maternal safety. This study examines temporal trends in ARAEs and nonanesthetic perioperative complications in CDs in New York hospitals. Data are from the State Inpatient Database for New York, 2003-2012. ARAEs, including minor and major ARAEs, and nonanesthetic perioperative complications were identified through International Classification of Diseases, Ninth Revision, Clinical Modification codes. Statistical significance in time trends was assessed using the Cochran-Armitage test and multivariable logistic regression. Of the 785,854 CDs studied, 5,715 (730 per 100,000; 95% CI, 710 to 750) had at least one ARAE and 7,040 had at least one perioperative complication (890 per 100,000; 95% CI, 870 to 920). The overall annual rate of ARAEs decreased from 890 per 100,000 in 2003 to 660 in 2012 (25% decrease; 95% CI, 16 to 34; P < 0.0001). The rate of minor ARAEs decreased 23% (95% CI, 13 to 32) and of major ARAEs decreased 43% (95% CI, 23 to 63). No decrease was observed in the rate of ARAEs for CDs performed under general anesthesia. The rate of nonanesthetic complications increased 47% (95% CI, 31 to 63; P < 0.0001). Anesthesia-related outcomes in cesarean deliveries appear to have improved significantly across hospitals in New York in the past decade. Perioperative nonanesthetic complications remain a serious healthcare issue.

  10. Roots of increased health care inequality in New York.

    PubMed

    Wallace, D

    1990-01-01

    During the 1970s, New York city experienced an epidemic of housing destruction by contagious fire and building abandonment. This epidemic was triggered by reductions in municipal services, especially fire control, in the poor areas of high population density and aging housing. The rapid loss of low rent housing led to a wave of forced internal migration of the poor within the city and overcrowding of areas adjacent to the burned out ones. The spread of overcrowding spread the high fire incidence. The massive upheaval resulted in destruction of social networks and in degraded living conditions. Public health, as measured by many indices such as disease incidence, substance abuse incidence, infant mortality, and incidence of homicide, deteriorated. This deterioration caused increased demand for hospital health care, especially emergency service. The data on average stay length in the poorest areas in comparison with wealthier areas hints that the overloading of the voluntary hospitals in the poorest areas has caused care rationing and greater inequality in access to care.

  11. Y2K medical disaster preparedness in New York City: confidence of emergency department directors in their ability to respond.

    PubMed

    Silber, S H; Oster, N; Simmons, B; Garrett, C

    2001-01-01

    To study the preparedness New York City for large scale medical disasters using the Year 2000 (Y2K) New Years Eve weekend as a model. Surveys were sent to the directors of 51 of the 9-1-1-receiving hospitals in New York City before and after the Y2K weekend. Inquiries were made regarding hospital activities, contingencies, protocols, and confidence levels in the ability to manage critical incidents, including weapons of mass destruction (WMD) events. Additional information was collected from New York City governmental agencies regarding their coordination and preparedness. The pre-Y2K survey identified that 97.8% had contingencies for loss of essential services, 87.0% instituted their disaster plan in advance, 90.0% utilized an Incident Command System, and 73.9% had a live, mock Y2K drill. Potential terrorism influenced Y2K preparedness in 84.8%. The post-Y2K survey indicated that the threat of terrorism influenced future preparedness in 73.3%; 73.3% had specific protocols for chemical; 62.2% for biological events; 51.1% were not or only slightly confident in their ability to manage any potential WMD incidents; and 62.2% felt very or moderately confident in their ability to manage victims of a chemical event, but only 35.6% felt similarly about victims of a biological incident. Moreover, 80% felt there should be government standards for hospital preparedness for events involving WMD, and 84% felt there should be government standards for personal protective and DECON equipment. In addition, 82.2% would require a moderate to significant amount of funding to effect the standards. Citywide disaster management was coordinated through the Mayor's Office of Emergency Management. Although hospitals were on a heightened state of alert, emergency department directors were not confident in their ability to evaluate and manage victims of WMD incidents, especially biological exposures. The New York City experience is an example for the rest of the nation to underscore the need

  12. Hazardous Waste Cleanup: Western New York Nuclear Service Center in West Valley, New York

    EPA Pesticide Factsheets

    This 3,300-acre site is located at 10282 Rock Springs Road in Ashford, New York and owned by New York State Energy Research & Development Authority (NYSERDA). A 167-acre portion is operated by the U.S. Department of Energy (See “West Valley Demonstration

  13. Survey of primary processors in New York, 1999.

    Treesearch

    Bruce Hansen; Sloane Crawford; Iris Baker; Melody Akers

    2002-01-01

    This report presents the results of a survey of primary wood processors in New York and surrounding states and Canada that relied on New York?s forests for at least a portion or their roundwood receipts in 1999. The previous survey of wood use and production in New York was conducted in 1993. At that time New York was a net importer of round wood. The latest study...

  14. Mental Disorder Hospitalizations among Submarine Personnel in the U.S. Navy.

    DTIC Science & Technology

    1988-03-10

    hospitalization rates ( Lilienfeld , 1980). T- tests were used to assess statistical signi- ficance of differences in descriptive variables (McNemar, 1969... Lilienfeld , D. E. Foundations of epidemiology. 2nd ed. New York: Oxford University Press, 1980. McNemar, Q. Psychological statistics. 4th ed. New York: Wiley...0 5/S I milI’l 11 1 ; 𔃻 28 112.5 U-2 11112.2 II~.2.4~ 11111J.6 MICROCOPY RESOLUTION TEST CHART NADONAL BUJR[AU OF STANDARDS Ib3 A IvM Mental

  15. New York Forests, 2012

    Treesearch

    Richard H. Widmann; Sloane Crawford; Cassandra M. Kurtz; Mark D. Nelson; Patrick D. Miles; Randall S. Morin; Rachel. Riemann

    2015-01-01

    This report summarizes the second annual inventory of New York's forests, conducted in 2008-2012. New York's forests cover 19.0 million acres; 15.9 million acres are classified as timberland and 3.1 million acres as reserved and other forest land. Forest land is dominated by the maple/beech/birch forest-type group that occupies more than half of the forest...

  16. New York's Forests 2007

    Treesearch

    Richard H. Widmann; Sloane Crawford; Charles Barnett; Brett J. Butler; Grant M. Domke; Douglas M. Griffith; Mark A. Hatfield; Cassandra M. Kurtz; Tonya W. Lister; Randall S. Morin; W. Keith Moser; Charles H. Perry; Rachel Riemann; Christopher W. Woodall

    2012-01-01

    This report summarizes the first full annual inventory of New York's forests, conducted in 2002-2007 by the U.S. Forest Service, Northern Research Station. New York's forests cover 19.0 million acres; 15.9 million acres are classified as timberland and 3.1 million acres as reserved and other forest land. Forest land is dominated by the maple/beech/birch...

  17. Designing New York's Future

    ERIC Educational Resources Information Center

    Giles, David

    2012-01-01

    The genius of Mayor Bloomberg's plan to develop a new applied sciences campus in New York City is that it acknowledges the increasingly pivotal role of academic institutions as drivers of local economic growth. At a time when large corporations may not be the reliable job producers they were in the past and cities like New York badly need to…

  18. Malpractice premiums and primary cesarean section rates in New York and Illinois.

    PubMed Central

    Rock, S M

    1988-01-01

    The fear of malpractice liability is mentioned frequently as a cause of increased cesarean section rates, but without quantitative investigations. This perception may be studied at an aggregate level by comparing malpractice insurance premiums, a proxy for liability risk, with primary cesarean section rates. Both New York and Illinois are divided into territories for insurance rates; the premium was uniform within each territory over the period studied for each specialty. Premiums for obstetricians were linked to birth and procedure data from New York and Illinois hospitals for 1981 and 1983, respectively, to determine whether there was a correlation between premium levels and the primary cesarean section rate. A statistically significant difference was found between mean cesarean rates by insurance premium territories in each State. A correlation was observed between increased insurance rates among territories and increased cesarean section rates. Based on these results, a substantial impact was found on delivery decisions resulting from the fear of malpractice suits. PMID:3140270

  19. Evaluation of Hospital-Based Palliative Care Programs.

    PubMed

    Hall, Karen Lynn; Rafalson, Lisa; Mariano, Kathleen; Michalek, Arthur

    2016-02-01

    This study evaluated current hospital-based palliative care programs using recommendations from the Center to Advance Palliative Care (CAPC) as a framework. Seven hospitals located in Buffalo, New York were included based on the existence of a hospital-based palliative care program. Data was collected from August through October of 2013 by means of key informant interviews with nine staff members from these hospitals using a guide comprised of questions based on CAPC's recommendations. A gap analysis was conducted to analyze the current state of each hospital's program based upon CAPC's definition of a quality palliative care program. The findings identify challenges facing both existing/evolving palliative care programs, and establish a foundation for strategies to attain best practices not yet implemented. This study affirms the growing availability of palliative care services among these selected hospitals along with opportunities to improve the scope of services in line with national recommendations. © The Author(s) 2014.

  20. Powassan meningoencephalitis, New York, New York, USA.

    PubMed

    Sung, Simon; Wurcel, Alysse G; Whittier, Susan; Kulas, Karen; Kramer, Laura D; Flam, Robin; Roberts, James Kirkland; Tsiouris, Simon

    2013-01-01

    Disease caused by Powassan virus (POWV), a tick-borne flavivirus, ranges from asymptomatic to severe neurologic compromise and death. Two cases of POWV meningoencephalitis in New York, USA, highlight diagnostic techniques, neurologic outcomes, and the effect of POWV on communities to which it is endemic.

  1. STS-42 Earth observation of New York City (NYC), New York

    NASA Image and Video Library

    1992-01-30

    STS-42 Earth observation taken aboard Discovery, Orbiter Vehicle (OV) 103, is of New York City (NYC), New York (41.0N, 74.0W). Snow cover highlights the large areas of development and the many reservoirs in this wintertime scene of the metropolitan NYC area. Features such as Central Park in Manhattan, the George Washington Bridge connecting Manhattan with New Jersey, street patterns in most of the boroughs, La Guardia and JFK airports in Queens, and the extensive harbor system are easily identified.

  2. STS-42 Earth observation of New York City (NYC), New York

    NASA Technical Reports Server (NTRS)

    1992-01-01

    STS-42 Earth observation taken aboard Discovery, Orbiter Vehicle (OV) 103, is of New York City (NYC), New York (41.0N, 74.0W). Snow cover highlights the large areas of development and the many reservoirs in this wintertime scene of the metropolitan NYC area. Features such as Central Park in Manhattan, the George Washington Bridge connecting Manhattan with New Jersey, street patterns in most of the boroughs, La Guardia and JFK airports in Queens, and the extensive harbor system are easily identified.

  3. Severe Maternal Morbidity and Hospital Cost among Hospitalized Deliveries in the United States.

    PubMed

    Chen, Han-Yang; Chauhan, Suneet P; Blackwell, Sean C

    2018-05-03

     The objective of this study was to estimate the contemporary national rate of severe maternal morbidity (SMM) and its associated hospital cost during delivery hospitalization.  We conducted a retrospective study identifying all delivery hospitalizations in the United States between 2011 and 2012. We used data from the National (Nationwide) Inpatient sample of the Healthcare Cost and Utilization Project. The delivery hospitalizations with SMM were identified by having at least one of the 25 previously established list of diagnosis and procedure codes. Aggregate and mean hospital costs were estimated. A generalized linear regression model was used to examine the association between SMM and hospital costs.  Of 7,438,946 delivery hospitalizations identified, the rate of SMM was 154 per 10,000 delivery hospitalizations. Without any SMM, the mean hospital cost was $4,300 and with any SMM, the mean hospital cost was $11,000. After adjustment, comparing to those without any SMM, the mean cost of delivery hospitalizations with any SMM was 2.1 (95% confidence interval: 2.1-2.2) times higher, and this ratio increases from 1.7-fold in those with only one SMM to 10.3-fold in those with five or more concurrent SMM.  The hospital cost with any SMM was 2.1 times higher than those without any SMM. Our findings highlight the need to identify interventions and guide research efforts to mitigate the rate of SMM and its economic burden. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Innovative Model for Information Assurance Curriculum: A Teaching Hospital

    ERIC Educational Resources Information Center

    Goel, Sanjay; Pon, Damira; Bloniarz, Peter; Bangert-Drowns, Robert; Berg, George; Delio, Vince; Iwan, Laura; Hurbanek, Thomas; Schuman, Sandoor P.; Gangolly, Jagdish; Baykal, Adnan; Hobbs, Jon

    2006-01-01

    A novel idea for information security education created by the New York State Center for Information Forensics and Assurance (CIFA) is presented. This new approach incorporates a teaching hospital model originally developed for medical training. In this model, information security problems from industry and government are solved and abstracted…

  5. Powassan Meningoencephalitis, New York, New York, USA

    PubMed Central

    Wurcel, Alysse G.; Whittier, Susan; Kulas, Karen; Kramer, Laura D.; Flam, Robin; Roberts, James Kirkland; Tsiouris, Simon

    2013-01-01

    Disease caused by Powassan virus (POWV), a tick-borne flavivirus, ranges from asymptomatic to severe neurologic compromise and death. Two cases of POWV meningoencephalitis in New York, USA, highlight diagnostic techniques, neurologic outcomes, and the effect of POWV on communities to which it is endemic. PMID:23969017

  6. From Data to Knowledge through Concept-oriented Terminologies

    PubMed Central

    Cimino, James J.

    2000-01-01

    Knowledge representation involves enumeration of conceptual symbols and arrangement of these symbols into some meaningful structure. Medical knowledge representation has traditionally focused more on the structure than the symbols. Several significant efforts are under way, at local, national, and international levels, to address the representation of the symbols though the creation of high-quality terminologies that are themselves knowledge based. This paper reviews these efforts, including the Medical Entities Dictionary (MED) in use at Columbia University and the New York Presbyterian Hospital. A decade's experience with the MED is summarized to serve as a proof-of-concept that knowledge-based terminologies can support the use of coded patient data for a variety of knowledge-based activities, including the improved understanding of patient data, the access of information sources relevant to specific patient care problems, the application of expert systems directly to the care of patients, and the discovery of new medical knowledge. The terminological knowledge in the MED has also been used successfully to support clinical application development and maintenance, including that of the MED itself. On the basis of this experience, current efforts to create standard knowledge-based terminologies appear to be justified. PMID:10833166

  7. Discovering disease associations by integrating electronic clinical data and medical literature.

    PubMed

    Holmes, Antony B; Hawson, Alexander; Liu, Feng; Friedman, Carol; Khiabanian, Hossein; Rabadan, Raul

    2011-01-01

    Electronic health record (EHR) systems offer an exceptional opportunity for studying many diseases and their associated medical conditions within a population. The increasing number of clinical record entries that have become available electronically provides access to rich, large sets of patients' longitudinal medical information. By integrating and comparing relations found in the EHRs with those already reported in the literature, we are able to verify existing and to identify rare or novel associations. Of particular interest is the identification of rare disease co-morbidities, where the small numbers of diagnosed patients make robust statistical analysis difficult. Here, we introduce ADAMS, an Application for Discovering Disease Associations using Multiple Sources, which contains various statistical and language processing operations. We apply ADAMS to the New York-Presbyterian Hospital's EHR to combine the information from the relational diagnosis tables and textual discharge summaries with those from PubMed and Wikipedia in order to investigate the co-morbidities of the rare diseases Kaposi sarcoma, toxoplasmosis, and Kawasaki disease. In addition to finding well-known characteristics of diseases, ADAMS can identify rare or previously unreported associations. In particular, we report a statistically significant association between Kawasaki disease and diagnosis of autistic disorder.

  8. Discovering Disease Associations by Integrating Electronic Clinical Data and Medical Literature

    PubMed Central

    Holmes, Antony B.; Hawson, Alexander; Liu, Feng; Friedman, Carol; Khiabanian, Hossein; Rabadan, Raul

    2011-01-01

    Electronic health record (EHR) systems offer an exceptional opportunity for studying many diseases and their associated medical conditions within a population. The increasing number of clinical record entries that have become available electronically provides access to rich, large sets of patients' longitudinal medical information. By integrating and comparing relations found in the EHRs with those already reported in the literature, we are able to verify existing and to identify rare or novel associations. Of particular interest is the identification of rare disease co-morbidities, where the small numbers of diagnosed patients make robust statistical analysis difficult. Here, we introduce ADAMS, an Application for Discovering Disease Associations using Multiple Sources, which contains various statistical and language processing operations. We apply ADAMS to the New York-Presbyterian Hospital's EHR to combine the information from the relational diagnosis tables and textual discharge summaries with those from PubMed and Wikipedia in order to investigate the co-morbidities of the rare diseases Kaposi sarcoma, toxoplasmosis, and Kawasaki disease. In addition to finding well-known characteristics of diseases, ADAMS can identify rare or previously unreported associations. In particular, we report a statistically significant association between Kawasaki disease and diagnosis of autistic disorder. PMID:21731656

  9. From data to knowledge through concept-oriented terminologies: experience with the Medical Entities Dictionary.

    PubMed

    Cimino, J J

    2000-01-01

    Knowledge representation involves enumeration of conceptual symbols and arrangement of these symbols into some meaningful structure. Medical knowledge representation has traditionally focused more on the structure than the symbols. Several significant efforts are under way, at local, national, and international levels, to address the representation of the symbols though the creation of high-quality terminologies that are themselves knowledge based. This paper reviews these efforts, including the Medical Entities Dictionary (MED) in use at Columbia University and the New York Presbyterian Hospital. A decade's experience with the MED is summarized to serve as a proof-of-concept that knowledge-based terminologies can support the use of coded patient data for a variety of knowledge-based activities, including the improved understanding of patient data, the access of information sources relevant to specific patient care problems, the application of expert systems directly to the care of patients, and the discovery of new medical knowledge. The terminological knowledge in the MED has also been used successfully to support clinical application development and maintenance, including that of the MED itself. On the basis of this experience, current efforts to create standard knowledge-based terminologies appear to be justified.

  10. Legionnaires' Disease Outbreaks and Cooling Towers, New York City, New York, USA.

    PubMed

    Fitzhenry, Robert; Weiss, Don; Cimini, Dan; Balter, Sharon; Boyd, Christopher; Alleyne, Lisa; Stewart, Renee; McIntosh, Natasha; Econome, Andrea; Lin, Ying; Rubinstein, Inessa; Passaretti, Teresa; Kidney, Anna; Lapierre, Pascal; Kass, Daniel; Varma, Jay K

    2017-11-01

    The incidence of Legionnaires' disease in the United States has been increasing since 2000. Outbreaks and clusters are associated with decorative, recreational, domestic, and industrial water systems, with the largest outbreaks being caused by cooling towers. Since 2006, 6 community-associated Legionnaires' disease outbreaks have occurred in New York City, resulting in 213 cases and 18 deaths. Three outbreaks occurred in 2015, including the largest on record (138 cases). Three outbreaks were linked to cooling towers by molecular comparison of human and environmental Legionella isolates, and the sources for the other 3 outbreaks were undetermined. The evolution of investigation methods and lessons learned from these outbreaks prompted enactment of a new comprehensive law governing the operation and maintenance of New York City cooling towers. Ongoing surveillance and program evaluation will determine if enforcement of the new cooling tower law reduces Legionnaires' disease incidence in New York City.

  11. Legionnaires’ Disease Outbreaks and Cooling Towers, New York City, New York, USA

    PubMed Central

    Fitzhenry, Robert; Cimini, Dan; Balter, Sharon; Boyd, Christopher; Alleyne, Lisa; Stewart, Renee; McIntosh, Natasha; Econome, Andrea; Lin, Ying; Rubinstein, Inessa; Passaretti, Teresa; Kidney, Anna; Lapierre, Pascal; Kass, Daniel; Varma, Jay K.

    2017-01-01

    The incidence of Legionnaires’ disease in the United States has been increasing since 2000. Outbreaks and clusters are associated with decorative, recreational, domestic, and industrial water systems, with the largest outbreaks being caused by cooling towers. Since 2006, 6 community-associated Legionnaires’ disease outbreaks have occurred in New York City, resulting in 213 cases and 18 deaths. Three outbreaks occurred in 2015, including the largest on record (138 cases). Three outbreaks were linked to cooling towers by molecular comparison of human and environmental Legionella isolates, and the sources for the other 3 outbreaks were undetermined. The evolution of investigation methods and lessons learned from these outbreaks prompted enactment of a new comprehensive law governing the operation and maintenance of New York City cooling towers. Ongoing surveillance and program evaluation will determine if enforcement of the new cooling tower law reduces Legionnaires’ disease incidence in New York City. PMID:29049017

  12. Public Health Concerns Associated with the New York City Blackout of 1977.

    PubMed

    Imperato, Pascal James

    2016-08-01

    The 1977 New York City blackout began at 9:36 p.m. on 13 July and lasted some 25 h until 10:39 p.m. on 14 July. The New York City Department of Health rapidly set up a Blackout Contingency Plan, established priorities, and mobilized its staff to address remedial interventions. Top priorities included water supplies, sewage disposal, perishable food supplies, hospital and emergency room services, solid waste disposal, beach contamination with untreated sewage , and assisting those on electrically powered home life support systems. The 1977 blackout occurred during an extended heat wave. An analysis of total deaths and deaths due to pulmonary and cardiovascular/renal diseases by day correlated with temperatures. However, there was no direct correlation with the blackout itself, in part perhaps because of the confounding influence of high temperatures. The increase of deaths on very hot days outside of the blackout period lends strong support to the relationship between increased deaths and high ambient temperatures. The 1977 New York City blackout was distinguished from those of 1965 and 2003 by violence, arson, and looting that occurred in several areas. These acts resulted in 204 civilian injuries, 436 police injuries, 80 firefighter injuries, and 1037 fires. The violence, arson, and looting caused extensive long-term physical and functional damage to certain areas of two boroughs of the city, Brooklyn and the Bronx. Although the New York City Department of Health had not previously established a disaster preparedness plan, its professionals quickly rose to the occasion because they were able to draw upon vast public health practice experience and ingenuity.

  13. Determinants of the direct cost of heart failure hospitalization in a public tertiary hospital.

    PubMed

    Parissis, John; Athanasakis, Kostas; Farmakis, Dimitrios; Boubouchairopoulou, Nadia; Mareti, Christina; Bistola, Vasiliki; Ikonomidis, Ignatios; Kyriopoulos, John; Filippatos, Gerasimos; Lekakis, John

    2015-02-01

    Heart failure (HF) is the first reason for hospital admission in the elderly and represents a major financial burden, the greatest part of which results from hospitalization costs. We sought to analyze current HF hospitalization-related expenditure and identify predictors of cost in a public tertiary hospital in Europe. We performed a retrospective chart review of 197 consecutive patients, aged 56±16years, 80% male, with left ventricular ejection fraction (LVEF) of 30±10%, hospitalized for HF in a major university hospital in Athens, Greece. The survey involved the number of hospitalization days, laboratory investigations and medical therapies. Patients who were hospitalized in CCU/ICU or underwent interventional procedures or device implantations were excluded from analysis. Costs were estimated based on the Greek healthcare system perspective in 2013. Patients were hospitalized for a median of 7 days with a total direct cost of €3198±3260/patient. The largest part of the expenses (79%) was attributed to hospitalization (ward), while laboratory investigations and medical treatment accounted for 17% and 4%, respectively. In multivariate analysis, pre-admission New York Heart Association NYHA class (p=0.001), serum creatinine (p=0.003) and NT-proBNP (p=0.004) were significant independent predictors of hospitalization cost. Direct cost of HF hospitalization is high particularly in patients with more severe symptoms, profound neurohormonal activation and renal dysfunction. Strategies to lower hospitalization rates are warranted in the current setting of financial constraints faced by many European countries. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Floods of 2011 in New York

    USGS Publications Warehouse

    Lumia, Richard; Firda, Gary D.; Smith, Travis L.

    2014-01-01

    Record rainfall combined with above-average temperatures and substantial spring snowmelt resulted in record flooding throughout New York during 2011. Rainfall totals in eastern New York were the greatest since 1895 and as much as 60 percent above the long-term average within the Catskill Mountains area and the Susquehanna River Basin. This report documents the three largest storms and resultant flooding during the year: (1) spring storm during April and May, (2) Tropical Storm Irene during August, and (3) remnants of Tropical Storm Lee during September. According to the Federal Emergency Management Agency (FEMA), the cost of these three storms exceeded $1 billion in Federal disaster assistance. A warm and wet spring in northern New York resulted in record flooding at 21 U.S. Geological Survey (USGS) active streamgages during late April to early May with the annual exceedance probabilities (AEPs) of 11 peak discharges equaling or exceeding 1 percent. Nearly 5 inches of rain during late April combined with a rapidly melting snowpack caused widespread flooding throughout northern New York, resulting in many road closures, millions of dollars in damages, and 23 counties declared disaster areas and eligible for public assistance. On May 6, Lake Champlain recorded its highest lake level in over 140 years. Hurricane Irene entered New York State on August 28 as a tropical storm and traveled up the eastern corridor of the State, leaving a path of destruction and damage never seen in many parts of New York. Thirty-one counties in New York were declared disaster areas with damages of over $1.3 billion dollars and 10 reported deaths. Storm rainfall exceeded 18 inches in the Catskill Mountains area of southeastern New York with many other areas of eastern New York receiving over 7 inches. Catastrophic flooding resulted from the extreme rainfall in many locations, including Schoharie Creek and its tributaries, the eastern Delaware River Basin, the Ausable and Bouquet River

  15. Predictors of nursing home residents' time to hospitalization.

    PubMed

    O'Malley, A James; Caudry, Daryl J; Grabowski, David C

    2011-02-01

    To model the predictors of the time to first acute hospitalization for nursing home residents, and accounting for previous hospitalizations, model the predictors of time between subsequent hospitalizations. Merged file from New York State for the period 1998-2004 consisting of nursing home information from the minimum dataset and hospitalization information from the Statewide Planning and Research Cooperative System. Accelerated failure time models were used to estimate the model parameters and predict survival times. The models were fit to observations from 50 percent of the nursing homes and validated on the remaining observations. Pressure ulcers and facility-level deficiencies were associated with a decreased time to first hospitalization, while the presence of advance directives and facility staffing was associated with an increased time. These predictors of the time to first hospitalization model had effects of similar magnitude in predicting the time between subsequent hospitalizations. This study provides novel evidence suggesting modifiable patient and nursing home characteristics are associated with the time to first hospitalization and time to subsequent hospitalizations for nursing home residents. © Health Research and Educational Trust.

  16. 49 CFR 372.235 - New York, NY.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false New York, NY. 372.235 Section 372.235... ZONES, AND TERMINAL AREAS Commercial Zones § 372.235 New York, NY. The zone adjacent to, and commercially a part of, New York, NY, within which transportation by motor vehicle, in interstate or foreign...

  17. Representativeness comparisons of nurse and computer charting of heart rate across nursing-intensity protocols.

    PubMed

    Luna, Jorge M; Yip, Natalie; Pivovarov, Rimma; Vawdrey, David K

    2016-08-01

    Clinical teams in acute inpatient settings can greatly benefit from automated charting technologies that continuously monitor patient vital status. NewYork-Presbyterian has designed and developed a real-time patient monitoring system that integrates vital signs sensors, networking, and electronic health records, to allow for automatic charting of patient status. We evaluate the representativeness (a combination of agreement, safety and timing) of a core vital sign across nursing intensity care protocols for preliminary feasibility assessment. Our findings suggest an automated way of summarizing heart rate provides representation of true heart rate status and can facilitate alternatives approaches to burdensome manual nurse charting of physiological parameters.

  18. 33 CFR 334.85 - New York Harbor, adjacent to the Stapleton Naval Station, Staten Island, New York; restricted area.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false New York Harbor, adjacent to the Stapleton Naval Station, Staten Island, New York; restricted area. 334.85 Section 334.85 Navigation and... RESTRICTED AREA REGULATIONS § 334.85 New York Harbor, adjacent to the Stapleton Naval Station, Staten Island...

  19. Suffrage in New York Counties.

    ERIC Educational Resources Information Center

    Stein, Maren A.

    1995-01-01

    Maintains that the expansion of voting rights to African Americans and women is an appropriate topic for Social Studies courses. Discusses suffrage in New York state between 1848 and 1920. Includes a table depicting the women's suffrage campaign in New York state and a list of other resources on the topic. (CFR)

  20. New York State's 1999 agritourism business study

    Treesearch

    Diane Kuehn; Duncan Hilchey

    2002-01-01

    Agritourism businesses (i.e., farm-based businesses that are open to visitors for recreational purposes) are becoming an important component of New York's tourism industry today. In order to estimate the economic impacts of these businesses on New York State and identify cost-effective management and marketing strategies for business owners, New York Sea Grant and...

  1. Patient Acuity and Operative Technique Associated with Post-Colectomy Mortality Across New York State: an Analysis of 160,792 Patients over 20 years.

    PubMed

    Lamm, Ryan; Mathews, Steven N; Yang, Jie; Park, Jihye; Talamini, Mark; Pryor, Aurora D; Telem, Dana

    2017-05-01

    This study sought to characterize in-hospital post-colectomy mortality in New York State. One hundred sixty thousand seven hundred ninety-two patients who underwent colectomy from 1995 to 2014 were analyzed from the all-payer New York Statewide Planning and Research Cooperative System (SPARCS) database. Linear trends of in-hospital mortality rate over 20 years were calculated using log-linear regression models. Chi-square tests were used to compare categorical variables between patients. Multivariable regression models were further used to calculate risk of in-hospital mortality associated with specific demographics, co-morbidities, and perioperative complications. From 1995 to 2014, 7308 (4.5%) in-hospital mortalities occurred within 30 days of surgery. Over this time period, the rate of overall in-hospital post-colectomy mortality decreased by 3.3% (6.3 to 3%, p < 0.0001). The risk of in-hospital mortality for patients receiving emergent and elective surgery decreased by 1% (RR 0.99 [0.98-1.00], p = 0.0005) and 5% (RR 0.95 [0.94-0.96], p < 0.0001) each year, respectively. Patients who underwent open surgeries were more likely to experience in-hospital mortality (adjusted OR 3.65 [3.16-4.21], p < 0.0001), with an increased risk of in-hospital mortality each year (RR 1.01 [1.00-1.03], p = 0.0387). Numerous other risk factors were identified. In-hospital post-colectomy mortality decreased at a slower rate in emergent versus elective surgeries. The risk of in-hospital mortality has increased in open colectomies.

  2. New York: Les ecoles entre SURR et STAR (New York: Schools between SURR and STAR).

    ERIC Educational Resources Information Center

    Ueberschlag, Roger

    1994-01-01

    Three problems of New York City (New York) schools--overpopulation, low academic standards, violence--are examined, and an effort led by parent and teacher organizations to improve conditions is described. Threatened closings (schools under registration review, SURR) and a program of violence reduction (Straight Talk about Risks, STAR) are noted.…

  3. Evacuate or Shelter-in-place? The Role of Corporate Memory and Political Environment in Hospital-evacuation Decision Making.

    PubMed

    Ricci, Karen A; Griffin, Anne R; Heslin, Kevin C; Kranke, Derrick; Dobalian, Aram

    2015-06-01

    Hospital-evacuation decisions are rarely straightforward in protracted advance-warning events. Previous work provides little insight into the decision-making process around evacuation. This study was conducted to identify factors that most heavily influenced the decisions to evacuate the US Department of Veterans Affairs (VA) New York Harbor Healthcare System's (NYHHS; New York USA) Manhattan Campus before Hurricane Irene in 2011 and before Superstorm Sandy in 2012. Semi-structured interviews with 11 senior leaders were conducted on the processes and factors that influenced the evacuation decisions prior to each event. The most influential factor in the decision to evacuate the Manhattan Campus before Hurricane Irene was New York City's (NYC's) hospital-evacuation mandate. As a federal facility, the Manhattan VA medical center (VAMC) was exempt from the city's order, but decision makers felt compelled to comply. In the case of Superstorm Sandy, corporate memory of a similar 1992 storm that crippled the Manhattan facility drove the decision to evacuate before the storm hit. Results suggest that hospital-evacuation decisions are confounded by political considerations and are influenced by past disaster experience. Greater shared situational awareness among at-risk hospitals, along with a more coordinated approach to evacuation decision making, could reduce pressure on hospitals to make these high-stakes decisions. Systematic mechanisms for collecting, documenting, and sharing lessons learned from past disasters are sorely needed at the institutional, local, and national levels.

  4. High Variability in Nosocomial Clostridium difficile Infection Rates Across Hospitals After Colorectal Resection.

    PubMed

    Aquina, Christopher T; Probst, Christian P; Becerra, Adan Z; Hensley, Bradley J; Iannuzzi, James C; Noyes, Katia; Monson, John R T; Fleming, Fergal J

    2016-04-01

    Hospital-acquired Clostridium difficile infection is associated with adverse patient outcomes and high medical costs. The incidence and severity of C. difficile has been rising in both medical and surgical patients. Our aim was to assess risk factors and variation associated with the development of nosocomial C. difficile colitis among patients undergoing colorectal resection. This was a retrospective cohort study. The study included segmental colectomy and proctectomy cases in New York State from 2005 to 2013. The study cohort included 150,878 colorectal resections. Patients with a documented previous history of C. difficile infection or residence outside of New York State were excluded. A diagnosis of C. difficile colitis either during the index hospital stay or on readmission within 30 days was the main measure. C. difficile colitis occurred in 3323 patients (2.2%). Unadjusted C. difficile colitis rates ranged from 0% to 11.3% among surgeons and 0% to 6.8% among hospitals. After controlling for patient, surgeon, and hospital characteristics using mixed-effects multivariable analysis, significant unexplained variation in C. difficile rates remained present across hospitals but not surgeons. Patient factors explained only 24% of the total hospital-level variation, and known surgeon and hospital-level characteristics explained an additional 8% of the total hospital-level variation. Therefore, ≈70% of the hospital variation in C. difficile infection rates remained unexplained by captured patient, surgeon, and hospital factors. Furthermore, there was an ≈5-fold difference in adjusted C. difficile rates across hospitals. A limited set of hospital and surgeon characteristics was available. Colorectal surgery patients appear to be at high risk for C. difficile infection, and alarming variation in nosocomial C. difficile infection rates currently exists among hospitals after colorectal resection. Given the high morbidity and cost associated with C. difficile colitis

  5. New York's Biracial Public Schools

    ERIC Educational Resources Information Center

    Clark, Kenneth

    1975-01-01

    In his testimony, before a May 1974 public hearing of the New York City Commission on Human Rights, the president of the Metropolitan Applied Research Center charges that New York City is operating a segregated school system, a dual school system, of the kind that the Supreme Court "Brown" decision declared to be illegal and…

  6. Pesticide Spraying for West Nile Virus Control and Emergency Department Asthma Visits in New York City, 2000

    PubMed Central

    Karpati, Adam M.; Perrin, Mary C.; Matte, Tom; Leighton, Jessica; Schwartz, Joel; Barr, R. Graham

    2004-01-01

    Pyrethroid pesticides were applied via ground spraying to residential neighborhoods in New York City during July–September 2000 to control mosquito vectors of West Nile virus (WNV). Case reports link pyrethroid exposure to asthma exacerbations, but population-level effects on asthma from large-scale mosquito control programs have not been assessed. We conducted this analysis to determine whether widespread urban pyrethroid pesticide use was associated with increased rates of emergency department (ED) visits for asthma. We recorded the dates and locations of pyrethroid spraying during the 2000 WNV season in New York City and tabulated all ED visits for asthma to public hospitals from October 1999 through November 2000 by date and ZIP code of patients’ residences. The association between pesticide application and asthma-related emergency visits was evaluated across date and ZIP code, adjusting for season, day of week, and daily temperature, precipitation, particulate, and ozone levels. There were 62,827 ED visits for asthma during the 14-month study period, across 162 ZIP codes. The number of asthma visits was similar in the 3-day periods before and after spraying (510 vs. 501, p = 0.78). In multivariate analyses, daily rates of asthma visits were not associated with pesticide spraying (rate ratio = 0.92; 95% confidence interval, 0.80–1.07). Secondary analyses among children and for chronic obstructive pulmonary disease yielded similar null results. This analysis shows that spraying pyrethroids for WNV control in New York City was not followed by population-level increases in public hospital ED visit rates for asthma. PMID:15289164

  7. The Influence of Early Ophthalmic Hospitals on the Journal.

    PubMed

    Pathipati, Akhilesh S; Tsai, James C

    2018-05-09

    To consider the American Journal of Ophthalmology's (AJO's) role not only as a forum to describe clinical and scientific advances but also as a record of institutional histories. We used the New York Eye and Ear Infirmary of Mount Sinai, the Massachusetts Eye and Ear Infirmary, and the Wills Eye Hospital as case studies on the Journal's role in documenting the people and organizations that have moved ophthalmology forward. Perspective. Using the ScienceDirect database, we conducted a literature search to gather all mentions of the 3 eye hospitals in the Journal's archives from 1918 to 2018. We evaluated those search results to identify a few of the individuals and articles that highlight how the history of eye institutions are reflected in the AJO. Searches for the aforementioned 3 hospitals yielded over 3400 results in Journal archives. These included articles on their histories, proceedings from clinical case conferences, profiles of prominent surgeons, and information about educational offerings, among others. Many of those articles were written by physicians from those institutions who also served on the AJO's editorial board or had a long history of publishing in the Journal. The AJO has played a crucial role in the last 100 years as a register of ophthalmic history. The New York Eye and Ear Infirmary of Mount Sinai, Massachusetts Eye and Ear Infirmary, and Wills Eye Hospital provide 3 examples of how that role manifests. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. 78 FR 63963 - Foreign-Trade Zone 1 and 111-New York, New York; Application for Merger and Reorganization Under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ... DEPARTMENT OF COMMERCE Foreign-Trade Zones Board [B-90-2013] Foreign-Trade Zone 1 and 111--New York, New York; Application for Merger and Reorganization Under Alternative Site Framework An application has been submitted to the Foreign-Trade Zones (FTZ) Board by the City of New York, grantee of FTZ 1 and 111, requesting authority to reorganize...

  9. New York hospital group striving for brand recognition. HealthStar Network.

    PubMed

    Herreria, J

    1998-01-01

    HealthStar Network established a new concept in its eastern market--a group of hospitals forming one association. Marketers of HealthStar are conducting a branding campaign to distinguish individual expertise under one umbrella company.

  10. Annals of the New York Academy of Sciences. Volume 423. Timing and Time Perception Held at New York on 10-13 May 1983,

    DTIC Science & Technology

    1984-05-13

    PART L TIME PERCEPTION Introduction JOHN GIBBON W. New York State Psychiatric Institute New York, New York 10032; and Department of Psychology ...34."’ Columbia University New York, New York 10027 LORRAINE ALLAN Department of Psychology McMaster University Hamilton, Ontario, Canada LAS 4Ki The study...of timing and time perception has a venerable dual history in experimental psychology . Animal psychologists studying learning and conditioning have

  11. New York City's Education Battles

    ERIC Educational Resources Information Center

    Meyer, Peter

    2008-01-01

    When Bloomberg gave his first State of the City address, in January, 2002, he announced his intention to seek mayoral control of the schools and abolish the infamous New York City Board of Education, which he called "a rinky-dink candy store." He joined a long list of New York mayors, educators, and business leaders who believed that the…

  12. New York: Multi-Speak City!

    ERIC Educational Resources Information Center

    New York City Economic Development Council, NY.

    This guide was written to help teachers make students aware of the multilingual and multi-ethnic nature of New York City in order to experience and explore different languages and customs. New York is a center for variety in language and culture in the areas of diplomacy, international commerce, media and communications, foods and fashion, the…

  13. New York City: Musically Speaking.

    ERIC Educational Resources Information Center

    Aiex, Nola Kortner

    New York City as a subject has fascinated generations of artists, writers, and musicians. However, the glamorous image of the city has changed over the years, and in the 1960s, popular music, in particular, began to reflect a utopia/dystopia dichotomy in relation to New York. During the past twenty years, six popular singer-songwriters who have…

  14. Pedestrian injuries due to collisions with bicycles in New York and California.

    PubMed

    Tuckel, Peter; Milczarski, William; Maisel, Richard

    2014-12-01

    Scant attention has been given to pedestrians injured in accidents resulting from collisions with cyclists. This scholarly neglect is surprising given the growing popularity of cycling. This study examines the incidence of pedestrians injured by cyclists in New York between 2004 to 2011 and in California from 2005 to 2011. The study also profiles the pedestrians injured in these two states during these two time frames. The data for this study are based upon patient-level hospital records from New York and California. The data for New York comes from the Statewide Planning and Research Cooperative System (SPARCS) under the auspices of New York State's Department of Health. The data for California come from two sources: the Healthcare Cost and Utilization Project (HCUP) and the California Office of Statewide Health Planning and Development. The rate of pedestrians injured in collisions with cyclists has decreased over time. This decline has occurred despite the increase in the number of cyclists in these states during this same time period. Two possible explanations for this decline are: (a) less exposure of children to cyclists, and (b) improvements in the cycling infrastructure. Although the rate of injuries to pedestrians from collisions with cyclists has been decreasing, improvements to the cycling infrastructure will need to continue. Bike lanes, particularly protected bike lanes, have been shown to be an effective way of reducing cycling-pedestrian accidents. The results of the current study are consistent with this research. Educational campaigns aimed at cyclists that emphasize the safety of all road users--including pedestrians--will also need to continue to assure that this downward trend in the number of accidents is not reversed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. A new casemix adjustment index for hospital mortality among patients with congestive heart failure.

    PubMed

    Polanczyk, C A; Rohde, L E; Philbin, E A; Di Salvo, T G

    1998-10-01

    Comparative analysis of hospital outcomes requires reliable adjustment for casemix. Although congestive heart failure is one of the most common indications for hospitalization, congestive heart failure casemix adjustment has not been widely studied. The purposes of this study were (1) to describe and validate a new congestive heart failure-specific casemix adjustment index to predict in-hospital mortality and (2) to compare its performance to the Charlson comorbidity index. Data from all 4,608 admissions to the Massachusetts General Hospital from January 1990 to July 1996 with a principal ICD-9-CM discharge diagnosis of congestive heart failure were evaluated. Massachusetts General Hospital patients were randomly divided in a derivation and a validation set. By logistic regression, odds ratios for in-hospital death were computed and weights were assigned to construct a new predictive index in the derivation set. The performance of the index was tested in an internal Massachusetts General Hospital validation set and in a non-Massachusetts General Hospital external validation set incorporating data from all 1995 New York state hospital discharges with a primary discharge diagnosis of congestive heart failure. Overall in-hospital mortality was 6.4%. Based on the new index, patients were assigned to six categories with incrementally increasing hospital mortality rates ranging from 0.5% to 31%. By logistic regression, "c" statistics of the congestive heart failure-specific index (0.83 and 0.78, derivation and validation set) were significantly superior to the Charlson index (0.66). Similar incrementally increasing hospital mortality rates were observed in the New York database with the congestive heart failure-specific index ("c" statistics 0.75). In an administrative database, this congestive heart failure-specific index may be a more adequate casemix adjustment tool to predict hospital mortality in patients hospitalized for congestive heart failure.

  16. Our Memory at Risk: Preserving New York's Unique Research Resources. A Report and Recommendations to the Citizens of New York.

    ERIC Educational Resources Information Center

    New York Document Conservation Advisory Council, Albany.

    This report, the culmination of the 3-year "New York Document Conservation Administration Training and Planning Project," represents a distillation of the best thinking about preservation issues in New York after an exhaustive process of consultation and review. Its thesis is that preservation of New York State's historical records, rare…

  17. Increasing Antibiotic Resistance in Shigella spp. from Infected New York City Residents, New York, USA.

    PubMed

    Murray, Kenya; Reddy, Vasudha; Kornblum, John S; Waechter, HaeNa; Chicaiza, Ludwin F; Rubinstein, Inessa; Balter, Sharon; Greene, Sharon K; Braunstein, Sarah L; Rakeman, Jennifer L; Dentinger, Catherine M

    2017-02-01

    Approximately 20% of Shigella isolates tested in New York City, New York, USA, during 2013-2015 displayed decreased azithromycin susceptibility. Case-patients were older and more frequently male and HIV infected than those with azithromycin-susceptible Shigella infection; 90% identified as men who have sex with men. Clinical interpretation guidelines for azithromycin resistance and outcome studies are needed.

  18. Are the nation's hospitals facing a capital crisis?

    PubMed

    Johnsson, J

    1990-07-20

    Are hospitals facing a capital crisis? Wall Street is taking a long, hard look at hospitals' bottom lines--and many analysts don't like what they see. Hospitals' increasing reliance on long-term debt, lower debt-service coverage ratios, and weakening performance indicators all signal a potentially volatile situation for some sectors of the field. Which hospitals are at risk? Experts point to hospitals in Southern California and New York. But others say that hospitals in moderate-size cities with 250 beds and $40 million or more in long-term debt are vulnerable. However, 40 percent of the 600 CEOs who responded to our Hamilton/KSA survey agree that the continued erosion of reimbursement will require a government bailout similar to the savings and loan industry. "A great deal depends on public policy," says Darrel Brownell, executive vice-president and chief financial officer, Memorial Health Services, a two-hospital system based in Long Beach, CA. "The government has the ability to maintain the industry in a stable condition, or it has the ability to force it into a bailout situation."

  19. 77 FR 67858 - New York Disaster #NY-00130

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-14

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13365 and 13366] New York Disaster NY-00130... declaration of a major disaster for the State of NEW YORK (FEMA-4085-DR), dated 10/30/2012. Incident..., Kings, Nassau, New York, Queens, Richmond, Suffolk. Contiguous Counties (Economic Injury Loans Only...

  20. 78 FR 48537 - New York Disaster # NY-00135

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13689 and 13690] New York Disaster NY-00135... Administrative declaration of a disaster for the State of New York dated 08/02/2013. Incident: Severe Storms and... the disaster: Primary Counties: Herkimer, Madison, Montgomery, Oneida. Contiguous Counties: New York...

  1. 76 FR 55721 - New York Disaster #NY-00108

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12776 and 12777] New York Disaster NY-00108... declaration of a major disaster for the State of New York (FEMA-4020-DR), dated 08/31/2011. Incident... Loans Only): New York: Broome, Chenango, Clinton, Columbia, Franklin, Hamilton, Montgomery, Orange...

  2. 76 FR 55153 - New York Disaster #NY-00104

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-06

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12758 and 12759] New York Disaster NY-00104... Administrative declaration of a disaster for the State of New York dated 08/26/2011. Incident: Severe storms and... the disaster: Primary Counties: Clinton, Franklin, Oneida, Warren. Contiguous Counties: New York...

  3. 76 FR 55721 - New York Disaster #NY-00109

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12778 and 12779] New York Disaster NY-00109... declaration of a major disaster for Public Assistance Only for the State of New York (FEMA- 4020-DR), dated 08..., Greene, Montgomery, Nassau, New York, Queens, Rensselaer, Richmond, Rockland, Schoharie, Suffolk, Ulster...

  4. The outbreak of West Nile virus infection in the New York City area in 1999.

    PubMed

    Nash, D; Mostashari, F; Fine, A; Miller, J; O'Leary, D; Murray, K; Huang, A; Rosenberg, A; Greenberg, A; Sherman, M; Wong, S; Layton, M

    2001-06-14

    In late August 1999, an unusual cluster of cases of meningoencephalitis associated with muscle weakness was reported to the New York City Department of Health. The initial epidemiologic and environmental investigations suggested an arboviral cause. Active surveillance was implemented to identify patients hospitalized with viral encephalitis and meningitis. Cerebrospinal fluid, serum, and tissue specimens from patients with suspected cases underwent serologic and viral testing for evidence of arboviral infection. Outbreak surveillance identified 59 patients who were hospitalized with West Nile virus infection in the New York City area during August and September of 1999. The median age of these patients was 71 years (range, 5 to 95). The overall attack rate of clinical West Nile virus infection was at least 6.5 cases per million population, and it increased sharply with age. Most of the patients (63 percent) had clinical signs of encephalitis; seven patients died (12 percent). Muscle weakness was documented in 27 percent of the patients and flaccid paralysis in 10 percent; in all of the latter, nerve conduction studies indicated an axonal polyneuropathy in 14 percent. An age of 75 years or older was an independent risk factor for death (relative risk adjusted for the presence or absence of diabetes mellitus, 8.5; 95 percent confidence interval, 1.2 to 59.1), as was the presence of diabetes mellitus (age-adjusted relative risk, 5.1; 95 percent confidence interval, 1.5 to 17.3). This outbreak of West Nile meningoencephalitis in the New York City metropolitan area represents the first time this virus has been detected in the Western Hemisphere. Given the subsequent rapid spread of the virus, physicians along the eastern seaboard of the United States should consider West Nile virus infection in the differential diagnosis of encephalitis and viral meningitis during the summer months, especially in older patients and in those with muscle weakness.

  5. Cholera--New York, 1991.

    PubMed

    1991-08-02

    Through June 26, 1991, cholera has been reported from seven countries in the Western Hemisphere: Brazil, Chile, Colombia, Ecuador, Mexico, Peru, and the United States. In the United States, a total of 14 confirmed cases of epidemic-associated cholera have been reported among persons in Florida (one) (1), Georgia (one) (2), New Jersey (eight) (1), and New York (four). This report summarizes information regarding the four cases reported in New York and describes a new laboratory procedure used to confirm the vehicle of transmission in this outbreak.

  6. 75 FR 22167 - New York Disaster #NY-00087

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-27

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12128 and 12129] New York Disaster NY-00087... Administrative declaration of a disaster for the State of New York dated 04/19/2010. Incident: Severe Storms and... adversely affected by the disaster: Primary Counties: Suffolk. Contiguous Counties: New York: Nassau. The...

  7. Devaney chaos, Li-Yorke chaos, and multi-dimensional Li-Yorke chaos for topological dynamics

    NASA Astrophysics Data System (ADS)

    Dai, Xiongping; Tang, Xinjia

    2017-11-01

    Let π : T × X → X, written T↷π X, be a topological semiflow/flow on a uniform space X with T a multiplicative topological semigroup/group not necessarily discrete. We then prove: If T↷π X is non-minimal topologically transitive with dense almost periodic points, then it is sensitive to initial conditions. As a result of this, Devaney chaos ⇒ Sensitivity to initial conditions, for this very general setting. Let R+↷π X be a C0-semiflow on a Polish space; then we show: If R+↷π X is topologically transitive with at least one periodic point p and there is a dense orbit with no nonempty interior, then it is multi-dimensional Li-Yorke chaotic; that is, there is a uncountable set Θ ⊆ X such that for any k ≥ 2 and any distinct points x1 , … ,xk ∈ Θ, one can find two time sequences sn → ∞ ,tn → ∞ with Moreover, let X be a non-singleton Polish space; then we prove: Any weakly-mixing C0-semiflow R+↷π X is densely multi-dimensional Li-Yorke chaotic. Any minimal weakly-mixing topological flow T↷π X with T abelian is densely multi-dimensional Li-Yorke chaotic. Any weakly-mixing topological flow T↷π X is densely Li-Yorke chaotic. We in addition construct a completely Li-Yorke chaotic minimal SL (2 , R)-acting flow on the compact metric space R ∪ { ∞ }. Our various chaotic dynamics are sensitive to the choices of the topology of the phase semigroup/group T.

  8. Non-hospital based registered nurses and the risk of bloodborne pathogen exposure.

    PubMed

    Gershon, Robyn R M; Qureshi, Kristine A; Pogorzelska, Monika; Rosen, Jonathan; Gebbie, Kristine M; Brandt-Rauf, Paul W; Sherman, Martin F

    2007-10-01

    The aim of this study was to assess the risk of blood and body fluid exposure among non-hospital based registered nurses (RNs) employed in New York State. The study population was mainly unionized public sector workers, employed in state institutions. A self-administered questionnaire was completed by a random stratified sample of members of the New York State Nurses Association and registered nurse members of the New York State Public Employees Federation. Results were reviewed by participatory action research (PAR) teams to identify opportunities for improvement. Nine percent of respondents reported at least one needlestick injury in the 12-month period prior to the study. The percutaneous injury (PI) rate was 13.8 per 100 person years. Under-reporting was common; 49% of all PIs were never formally reported and 70% never received any post-exposure care. Primary reasons for not reporting included: time constraints, fear, and lack of information on reporting. Significant correlates of needlestick injuries included tenure, patient load, hours worked, lack of compliance with standard precautions, handling needles and other sharps, poor safety climate, and inadequate training and availability of safety devices (p<0.05). PAR teams identified several risk reduction strategies, with an emphasis on safety devices. Non-hospital based RNs are at risk for bloodborne exposure at rates comparable to hospital based RNs; underreporting is an important obstacle to infection prevention, and primary and secondary risk management strategies appeared to be poorly implemented. Intervention research is warranted to evaluate improved risk reduction practices tailored to this population of RNs.

  9. Impact of Local Resources on Hospitalization Patterns of Medicare Beneficiaries and Propensity to Travel outside Local Markets

    ERIC Educational Resources Information Center

    Basu, Jayasree; Mobley, Lee R.

    2010-01-01

    Purpose: To examine how local health care resources impact travel patterns of patients age 65 and older across the rural urban continuum. Methods: Information on inpatient hospital discharges was drawn from complete 2004 hospital discharge files from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID) for New York,…

  10. Association of Very Low-Volume Practice With Vascular Surgery Outcomes in New York.

    PubMed

    Mao, Jialin; Goodney, Philip; Cronenwett, Jack; Sedrakyan, Art

    2017-08-01

    Little research has focused on very low-volume surgery, especially in the context of decreasing vascular surgery volume with the adoption of endovascular procedures. To investigate the existence and outcomes of open abdominal aortic aneurysm repair (OAR) and carotid endarterectomy (CEA) performed by very low-volume surgeons in New York. This cohort study examined inpatient data of patients undergoing elective OAR or CEA from 2000 to 2014 from all New York hospitals. Surgeons who performed 1 or less designated procedure per year on average were considered very low volume, as opposed to higher-volume surgeons. Temporal trends of the existence of very low-volume practice were evaluated. Hierarchical logistic regression was used to compare in-hospital outcomes and health care resource use between patients treated by very low-volume surgeons and higher-volume surgeons for both OAR and CEA, adjusting for patient, surgeon, and hospital characteristics. There were 8781 OAR procedures and 68 896 CEA procedures included in the study. The mean (SD) patient age was 71.7 (8.4) years for OAR and 71.5 (9.1) years for CEA. A total of 614 surgeons performed OAR and 1071 performed CEA in New York during the study period. Of these, 318 (51.8%) and 512 (47.8%), respectively, were very low-volume surgeons. Very low-volume surgeons were less likely to be vascular surgeons. The number and proportion of very low-volume surgeons decreased over years. Compared with patients treated by higher-volume surgeons, those treated by very low-volume surgeons were more likely to have higher in-hospital mortality (odds ratio [OR], 2.09; 95% CI, 1.41-3.08) following OAR and higher risks of postoperative myocardial infarction (OR, 1.83; 95% CI, 1.03-3.26) and stroke (OR, 1.78; 95% CI, 1.21-2.62) following CEA. Patients treated by very low-volume surgeons also had greater health care resource use following both surgeries, including prolonged length of stay (OR, 1.37; 95% CI, 1.11-1.70) following OAR as

  11. Respiratory hospitalizations in association with fine PM and its ...

    EPA Pesticide Factsheets

    Despite observed geographic and temporal variation in particulate matter (PM)-related health morbidities, only a small number of epidemiologic studies have evaluated the relation between PM2.5 chemical constituents and respiratory disease. Most assessments are limited by inadequate spatial and temporal resolution of ambient PM measurements and/or by their approaches to examine the role of specific PM components on health outcomes. In a case-crossover analysis using daily average ambient PM2.5 total mass and species estimates derived from the Community Multiscale Air Quality (CMAQ) model and available observations, we examined the association between the chemical components of PM (including elemental and organic carbon, sulfate, nitrate, ammonium, and other remaining) and respiratory hospitalizations in New York State. We evaluated relationships between levels (low, medium, high) of PM constituent mass fractions, and assessed modification of the PM2.5–hospitalization association via models stratified by mass fractions of both primary and secondary PM components. In our results, average daily PM2.5 concentrations in New York State were generally lower than the 24-hr average National Ambient Air Quality Standard (NAAQS). Year-round analyses showed statistically significant positive associations between respiratory hospitalizations and PM2.5 total mass, sulfate, nitrate, and ammonium concentrations at multiple exposure lags (0.5–2.0% per interquartile range [IQR

  12. Syringe Disposal among Injection Drug Users in Harlem and the Bronx during the New York State Expanded Syringe Access Demonstration Program

    ERIC Educational Resources Information Center

    Cleland, Charles M.; Deren, Sherry; Fuller, Crystal M.; Blaney, Shannon; McMahon, James M.; Tortu, Stephanie; Des Jarlais, Don C.; Vlahov, David

    2007-01-01

    Effective January 1, 2001, New York State enacted the Expanded Syringe Access Demonstration Program (ESAP), allowing syringes to be sold in pharmacies without a prescription or dispensed through doctors, hospitals, and clinics to adults. A concern in the assessment of ESAP is its effects on syringe disposal practices. Syringe use data regarding…

  13. New York City, Hudson River, NY, USA

    NASA Technical Reports Server (NTRS)

    1991-01-01

    This color infrared photo of New York City, Hudson River, NY, (41.0N, 74.0W) shows a unique view of the dense urban development of the New York City metropolitan area in downstate New York, Long Island and New Jersey. The heavily populated city areas appear as white or gray while vegetated areas appear as shades of red. Central park clearly shows up on Manhattan Island as an illustration of the delineation between cultural and natural features.

  14. 76 FR 71966 - TC Ravenswood, LLC v. New York Independent System Operator, Inc., New York State Reliability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL12-9-000] TC Ravenswood... Procedures, 18 CFR 385.206, TC Ravenswood, LLC (Complainant) filed a complaint against the New York... York Public Service Commission. \\1\\ TC Ravenswood, LLC, 136 FERC ] 61,213 (2011). The Complainant...

  15. The ecological relationship between deprivation, social isolation and rates of hospital admission for acute psychiatric care: a comparison of London and New York City.

    PubMed

    Curtis, Sarah; Copeland, Alison; Fagg, James; Congdon, Peter; Almog, Michael; Fitzpatrick, Justine

    2006-03-01

    We report on comparative analyses of small area variation in rates of acute hospital admissions for psychiatric conditions in Greater London around the year 1998 and in New York City (NYC) in 2000. Based on a theoretical model of the factors likely to influence psychiatric admission rates, and using data from the most recent population censuses and other sources, we examine the association with area indicators designed to measure access to hospital beds, socio-economic deprivation, social fragmentation and ethnic/racial composition. We report results on admissions for men and women aged 15-64 for all psychiatric conditions (excluding self-harm), drug-related substance abuse/addiction, schizophrenia and affective disorders. The units of analysis in NYC were 165 five-digit Zip Code Areas and, in London, 760 electoral wards as defined in 1998. The analysis controls for age and sex composition and, as a proxy for access to care, spatial proximity to hospitals with psychiatric beds. Poisson regression modeling incorporating random effects was used to control for both overdispersion in the counts of admissions and for the effects of spatial autocorrelation. The results for NYC and London showed that local admission rates for all types of condition were positively and significantly associated with deprivation and the association is independent of demographic composition or 'access' to beds. In NYC, social fragmentation showed a significant association with admissions due to affective disorders and schizophrenia, and for drug dependency among females. Racial minority concentration was significantly and positively associated with admissions for schizophrenia. In London, social fragmentation was associated positively with admissions for men and women due to schizophrenia and affective disorders. The variable measuring racial/ethnic minority concentration for London wards showed a negative association with admission rates for drug dependency and for affective disorders. We

  16. Caribbean Life in New York City: Sociocultural Dimensions.

    ERIC Educational Resources Information Center

    Sutton, Constance R., Ed.; Chaney, Elsa M., Ed.

    This book comprises the following papers discussing Caribbean life in New York City: (1) The Context of Caribbean Migration (Elsa M. Chaney); (2) The Caribbeanization of New York City and the Emergence of a Transnational Socio-Cultural System (Constance R. Sutton); (3) New York City and Its People: An Historical Perspective Up to World War II…

  17. Managing acute cholecystitis among Medicaid insured in New York State: opportunities to optimize care.

    PubMed

    Stey, Anne M; Greenstein, Alexander J; Aufses, Arthur; Moskowitz, Alan J; Egorova, Natalia N

    2018-05-01

    Identifying sources of unnecessary cost within Medicaid will help focus cost containment efforts. This study sought to identify differences in surgical management and associated costs of cholecystitis between Medicaid and privately insured in New York State. The New York State all-payer mandatory discharge database from 2003 to 2013, had 297,635 patients with Medicaid (75,512) and privately (222,123) insurance who underwent cholecystectomy for cholecystitis. Patients were stratified by insurance. Four surgical management approaches were delineated based on cholecystectomy timing: primary, interval, emergency, and delayed cholecystectomy. Delayed cholecystectomy was defined as more than one hospital visit from diagnosis to definitive cholecystectomy. Medicaid and privately insured patients were propensity score matched. Surgical management approach and associated costs were compared between matched cohorts. A greater proportion of Medicaid patients underwent delayed cholecystectomy compared to matched privately insured patients, 8.5 versus 4.8%; P < 0.001. Primary initial cholecystectomy was performed in fewer Medicaid compared to privately insured patients, 55.4 versus 66.0%, P < 0.001. Primary initial cholecystectomy was the cheapest surgical management approach, with the median cost of $3707, and delayed cholecystectomy was the most expensive, $12,212, P < 0.001. The median cost per Medicaid patient was $6170 versus $4804 per matched privately insured patient, P < 0.001. The annual predicted cost savings for New York State Medicaid would be $13,097,371, if the distribution of surgical management approaches were proportionally similar to private insurance. Medicaid patients with cholecystitis were more frequently managed with delayed cholecystectomy than privately insured patients, which had substantial cost implications for the New York Medicaid Program.

  18. New York State Technical & Economic MAGLEV Evaluation

    DOT National Transportation Integrated Search

    1991-06-01

    The New York State Energy Research and Development Authority, with the : assistance of the Departments of Transportation, Economic Development, Environmental Conservation, and the New York State Thruway Authority, is undertaking a comprehensive, syst...

  19. New York Racing Association (NYRA) Clean Water Act Settlement

    EPA Pesticide Factsheets

    The New York Racing Association (NYRA) is a not-for-profit corporation that operates the Aqueduct Racetrack in Ozone Park, New York, pursuant to a franchise agreement with the State of New York, who owns the facility.

  20. Connected Vehicle Pilot Deployment Program : New York City, New York

    DOT National Transportation Integrated Search

    2017-03-03

    The New York City Connected Vehicle Pilot aims to improve the safety of travelers and pedestrians in the city through the deployment of connected vehicle technologies. This objective directly aligns with the city's Vision Zero initiative, which began...

  1. Multi-Union Efforts in New York

    ERIC Educational Resources Information Center

    Newfield, Marcia

    2008-01-01

    The Professional Staff Congress (PSC), the union for twenty-two thousand faculty and staff members at the City University of New York (CUNY), has been successful at gaining New York State aid for tuition remission for doctoral students and health insurance for graduate student employees, increasing budget allotments to CUNY, and obtaining transit…

  2. Building New York City's Innovation Economy

    ERIC Educational Resources Information Center

    O'Grady, Jim; Bowles, Jonathan

    2009-01-01

    Academic research institutions have long been important economic anchors for New York City. They provide thousands of jobs and serve as a magnet for talented students and faculty, who inject hundreds of millions of dollars into the local economy through federal research grants. Yet, even though New York's concentration of top-fight scientific…

  3. Consistency of the New York State bridge inspection program.

    DOT National Transportation Integrated Search

    2013-09-01

    The New York State Department of Transportation (NYSDOT) maintains an inventory of over 17,000 highway : bridges across the state. As per New York States Uniform Code of Bridge Inspections, all bridges in New York : State are inspected biennially,...

  4. Network information security in a phase III Integrated Academic Information Management System (IAIMS).

    PubMed

    Shea, S; Sengupta, S; Crosswell, A; Clayton, P D

    1992-01-01

    The developing Integrated Academic Information System (IAIMS) at Columbia-Presbyterian Medical Center provides data sharing links between two separate corporate entities, namely Columbia University Medical School and The Presbyterian Hospital, using a network-based architecture. Multiple database servers with heterogeneous user authentication protocols are linked to this network. "One-stop information shopping" implies one log-on procedure per session, not separate log-on and log-off procedures for each server or application used during a session. These circumstances provide challenges at the policy and technical levels to data security at the network level and insuring smooth information access for end users of these network-based services. Five activities being conducted as part of our security project are described: (1) policy development; (2) an authentication server for the network; (3) Kerberos as a tool for providing mutual authentication, encryption, and time stamping of authentication messages; (4) a prototype interface using Kerberos services to authenticate users accessing a network database server; and (5) a Kerberized electronic signature.

  5. Status of the cyclotron/P.E.T. facility at the State University of New York at Buffalo

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Toorongian, S.A.; Haka, M.S.

    1994-12-31

    A new P.E.T./Cyclotron facility has been constructed on the Main St. campus of the State University of New York at Buffalo to service the needs of Nuclear Medicine departments in Buffalo and throughout the Western New York area. This facility is jointly funded and operated by S.U.N.Y. and the Veterans Administration. The cyclotron, as well as the research labs and a nuclear pharmacy to prepare non-positron emitting radiopharmaceuticals, are located in a newly constructed facility on campus. The P.E.T. scanner is located in the Veterans Administration Hospital adjacent to the campus. The two annexes are connected by a pneumatic transportmore » {open_quotes}rabbit{close_quotes} system. The cyclotron and all radiopharmaceutical synthesis apparatus have been purchased from Ion Beam Applications s.a. of Lovain-la-Neuve Belgium.« less

  6. Hispanic Diversity in New York City.

    ERIC Educational Resources Information Center

    Gurak, Douglas T.; And Others

    1980-01-01

    This issue of the Hispanic Research Center's journal contains four articles which focus on various aspects of the Hispanic community in New York City. In the first article, Douglas T. Gurak and Lloyd H. Rogler use data from censuses, ethnographic accounts, and public documents to profile New York City's Hispanic population. They review the…

  7. City Schools: Lessons from New York.

    ERIC Educational Resources Information Center

    Ravitch, Diane, Ed.; Viteritti, Joseph P., Ed.

    This book presents a collection of essays by researchers and educators that examine the largest school system in the U.S.--the New York City school system. There are 5 parts with 15 chapters. Part 1, "Education in the City," includes: (1) "Schooling in New York City: The Socioeconomic Context" (Emanuel Tobier) and (2)…

  8. Publication List - New York State Museum.

    ERIC Educational Resources Information Center

    New York State Museum, Albany.

    Presented is a list of publications in six areas: (1) Anthropology and Archeology, (2) Botany, (3) Entomology, (4) Zoology, (5) Geology and Paleontology, and (6) Miscellaneous. This list was produced by the New York State Department of Education in cooperation with the New York State Museum. The list includes the publication number, author(s),…

  9. The New York State Mentoring Program.

    ERIC Educational Resources Information Center

    Cuomo, Matilda R.

    This conference address discusses New York State programs for children and families, focusing on a mentoring program. New York State has 44 rural counties, which comprise 80% of the state's total area. Rural schools face limited financial resources and access to services. Rural school children are more likely to face failure than urban or suburban…

  10. Before the Vaccines: Medical Treatments of Acute Paralysis in the 1916 New York Epidemic of Poliomyelitis

    PubMed Central

    H.V, Wyatt

    2014-01-01

    Hospitals in New York were overwhelmed by the epidemic. With nothing known about the virus, most cases were treated with traditional or symptomatic remedies. New treatments were made though unsuccessful. Serum from various sources was given although it was many years before this was found to be ineffectual. Lumbar puncture was made, sometimes with additions. Although this became standard treatment, there were some who thought it was harmful. Many histories of polio ignore treatment. PMID:25598852

  11. 76 FR 29797 - Westpoint Home, Inc., New York Corporate Sales Office, New York, NY, Including Employees Working...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-23

    ...,218B, TA-W-74,218C, TA-W-74,218D] Westpoint Home, Inc., New York Corporate Sales Office, New York, NY... Home, Inc., Plano, TX Sales Office, Plano, TX; Westpoint Home, Inc., Daleville, IN Sales Office, Daleville, IN; Westpoint Home, Inc., Rogers, AR Sales Office, Rogers, AR; Westpoint Home, Inc., Winston...

  12. Epidemiology of Infective Endocarditis in Rural Upstate New York, 2011 - 2016.

    PubMed

    Fatima, Saeeda; Dao, Benajmin; Jameel, Ayesha; Sharma, Konika; Strogatz, David; Scribani, Melissa; Rammohan, Harish Raj Seetha

    2017-09-01

    The epidemiology of infective endocarditis (IE) depends on a number of host factors whose prevalence can vary globally. The usual patient population affected by IE is sicker and older, often with many comorbid conditions. The risk is growing in younger populations due to the emerging epidemic of intravenous (IV) drug use. We have performed a temporal trend analysis of various factors of IE in the rural counties covering a major part of central Upstate New York. We performed a retrospective analysis of electronic medical records of patients who were admitted in a tertiary care hospital in rural Upstate New York and diagnosed with IE from January 1, 2011 to December 31, 2016. Forty-five patients were identified with definite IE and nine with possible IE. Total incidence of IE was 3.5 cases per 100,000 person years in the total population and 4.4 if we consider total population ≥ 18 years in the denominator. A significant (P = 0.022) increase in incidence of IE from 2011 to 2016 was seen by univariate analysis. Incidence was higher in males (P = 0.029) and for those aged 65 or older (P = 0.0003). IV drug use among cases is noted to be more prevalent in 2015 and 2016 compared to previous years. In this study of patients in a rural region of New York, an increase in the incidence of IE was seen over the study period with changes in patient characteristics and etiology over this time. We speculate that an increase in IV drug use could be a leading factor in the recent and future increased incidence of IE in the area.

  13. Epidemiology of Infective Endocarditis in Rural Upstate New York, 2011 - 2016

    PubMed Central

    Fatima, Saeeda; Dao, Benajmin; Jameel, Ayesha; Sharma, Konika; Strogatz, David; Scribani, Melissa; Rammohan, Harish Raj Seetha

    2017-01-01

    Background The epidemiology of infective endocarditis (IE) depends on a number of host factors whose prevalence can vary globally. The usual patient population affected by IE is sicker and older, often with many comorbid conditions. The risk is growing in younger populations due to the emerging epidemic of intravenous (IV) drug use. We have performed a temporal trend analysis of various factors of IE in the rural counties covering a major part of central Upstate New York. Methods We performed a retrospective analysis of electronic medical records of patients who were admitted in a tertiary care hospital in rural Upstate New York and diagnosed with IE from January 1, 2011 to December 31, 2016. Forty-five patients were identified with definite IE and nine with possible IE. Results Total incidence of IE was 3.5 cases per 100,000 person years in the total population and 4.4 if we consider total population ≥ 18 years in the denominator. A significant (P = 0.022) increase in incidence of IE from 2011 to 2016 was seen by univariate analysis. Incidence was higher in males (P = 0.029) and for those aged 65 or older (P = 0.0003). IV drug use among cases is noted to be more prevalent in 2015 and 2016 compared to previous years. Conclusion In this study of patients in a rural region of New York, an increase in the incidence of IE was seen over the study period with changes in patient characteristics and etiology over this time. We speculate that an increase in IV drug use could be a leading factor in the recent and future increased incidence of IE in the area. PMID:28811851

  14. 75 FR 29471 - The New York North Shore Helicopter Route

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-26

    ...-0302; Notice No. 10-08] RIN 2120-AJ75 The New York North Shore Helicopter Route AGENCY: Federal... action would require helicopter operators to use the New York North Shore Route when operating in that area of Long Island, New York. The North Shore Route was added to the New York Helicopter Route [[Page...

  15. Transforming New York City's Public Schools

    ERIC Educational Resources Information Center

    Bartholomew, Barbara

    2006-01-01

    In 2002, Michael Bloomberg, New York City's newly elected mayor, hoped to fix his city's public schools, which were widely perceived as plagued by a gamut of problems that ranged from low test scores to patronage-riddled schools and districts. A special bill approved by the New York State Legislature made Bloomberg solely accountable to the New…

  16. Charity Hospital: from the beginning to either a new beginning or the end.

    PubMed

    Hoover, Eddie L

    2007-05-01

    Through epidemics, wars, hurricanes, pirates and politics, Charity Hospital has served the indigent population of New Orleans and Louisiana since May 10, 1736 as the second oldest continuing public hospital in the country following Bellevue in New York City, which opened six weeks earlier on March 31, 1736. The first Charity facility was financed by the estate of boat builder Jean Louis, whose will recorded, "a sale shall be made of all that remains, which, together with my small lot, I bequeath to serve in perpetuity to the founding of a hospital for the sick of the City of New Orleans...".

  17. New York Water-Use Program and data, 2000

    USGS Publications Warehouse

    Lumia, Deborah S.; Linsey, Kristin S.

    2005-01-01

    New York ranked third after California and Texas in withdrawals of freshwater for public supply, in the withdrawal of fresh surface water for public-water supply, in total population, and in number of people served by public-water supplies. New York ranked sixth in total withdrawals for the generation of thermoelectric power and total surface-water withdrawals. Finally, New York ranked fourth in withdrawals of ground water for public supply.

  18. Hospital costs and specialization: benefits of limiting the number of product lines.

    PubMed

    Eastaugh, Steven R

    2009-01-01

    Trends in hospital specialization are studied using multiple regression analysis for the period 1999-2008. The observed 31.3 percent rise in specialization was associated with a 9.5 percent decline in unit cost per admission. The number of specialized hospitals has grown by 149 percent in the past decade. Other hospitals are getting more specialized by reducing their product lines. Specialization has been highest in competitive West Coast markets and lowest in the rate-regulated states (New York and Massachusetts). Hospitals have less incentive to contain costs by decreasing the array of services offered in stringent rate-setting states. The term "underspecialization" is advanced to capture the inability of some hospitals to selectively prune out product lines in order to specialize. Such hospitals spread resources so thin that many good departments suffer. Unit cost per case (DRG-adjusted) is higher in the less specialized hospitals.

  19. 75 FR 41558 - New York Disaster Number NY-00089

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-16

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12123 and 12124] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the State of New York, dated 04/16/2010, is hereby amended to re-establish the incident period for...

  20. 76 FR 56860 - New York Disaster Number NY-00109

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12778 and 12779] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the State of NEW YORK, dated 08/31/2011, is hereby amended to include the following areas as adversely...

  1. 78 FR 47817 - New York Disaster Number NY-00136

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-06

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13667 and 13668] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the State of New York, dated 07/12/2013, is hereby amended to re-establish the incident period for...

  2. 76 FR 68804 - New York Disaster Number NY-00113

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-07

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12858 and 12859] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the State of New York, dated 09/23/2011, is hereby amended to include the following areas as adversely...

  3. 76 FR 62131 - New York Disaster Number NY-00113

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-06

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12858 and 12859] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance only for the State of New York... the State of New York, dated 09/23/2011, is hereby amended to include the following areas as adversely...

  4. 78 FR 47816 - New York Disaster Number NY-00136

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-06

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13667 and 13668] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the State of NEW YORK, dated 07/12/2013, is hereby amended to include the following areas as adversely...

  5. 76 FR 40767 - New York Disaster Number NY-00105

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-11

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12634 and 12635] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... Private Non-Profit organizations in the State of New York, dated 06/10/2011, is hereby amended to include...

  6. 76 FR 64420 - New York Disaster Number NY-00113

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-18

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12858 and 12859] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the State of New York, dated 09/23/2011, is hereby amended to include the following areas as adversely...

  7. 76 FR 56853 - New York Disaster Number NY-00109

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12778 and 12779] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the State of New York, dated 08/31/2011, is hereby amended to establish the incident period for this...

  8. 76 FR 67245 - New York Disaster Number NY-00113

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-31

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12858 and 12859] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the State of New York, dated 09/23/2011, is hereby amended to include the following areas as adversely...

  9. 76 FR 63699 - New York Disaster Number NY-00113

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12858 and 12859] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the State of New York, dated 09/23/2011, is hereby amended to include the following areas as adversely...

  10. 76 FR 66111 - New York Disaster Number NY-00113

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-25

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12858 and 12859] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the State of New York, dated 09/23/2011, is hereby amended to include the following areas as adversely...

  11. 75 FR 41558 - New York Disaster Number NY-00089

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-16

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12123 and 12124] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the State of New York, dated 04/16/2010, is hereby amended to include the following areas as adversely...

  12. Special report. Hospitals that are becoming 'hotel friendly' to guests ... and the role played by security officers.

    PubMed

    1996-01-01

    Faced with increasing competition, hospitals in New York City are developing programs to become more user friendly and, like hotels, to treat patients more as "guests" than as "customers." These programs, which have particular applications for security personnel, are also seeking to improve communications and relationships among the hospital's medical staff and other employees. In this report, we'll describe some of these efforts in which hospitals are turning to hoteliers, consultants, and others for advice in the area of customer service, and the role seen for hospital security.

  13. The Information Needs of Practicing Physicians in Northeastern New York State*

    PubMed Central

    Strasser, Theresa C.

    2012-01-01

    The information needs of practicing physicians in seventeen counties of upstate New York were surveyed by questionnaire. A 45.6% response, or 258 usable replies, was obtained. Computer-aided market analysis indicated that the areas of greatest need for improved information were new developments in specialties and government regulations relating to health care. Sources most frequently used were journal papers, colleagues, and books, in that order. Specialty-related differences occurred with both specific information needs and source use. Degree date, geographical location, and type of practice (hospital, nonhospital, private, and so on), and involvement in research or education were also analyzed in relation to information needs and sources. Implications for library service are discussed. PMID:23509429

  14. First Ladies of New York State.

    ERIC Educational Resources Information Center

    Begos, Jane D.; And Others

    These documents are designed to help seventh grade students in New York State understand the role of women and the structure and function of the family in both New York and U.S. history. Students are introduced to the state's first two first ladies: Cornelia Tappen Clinton (1744-1800) and Sarah Livingston Jay (1756-1802). Between 1777 and 1804,…

  15. Hospital for Special Surgery: origin and early history first site 1863-1870.

    PubMed

    Levine, David B

    2005-09-01

    Hospital for Special Surgery (HSS) originated as the Hospital for the Ruptured and Crippled (R&C) 142 years ago in New York City. As the first and only orthopaedic hospital of its kind in this country, it was located in the residence of its founder James Knight on Second Avenue, south of Sixth Street, and started with 28 inpatient beds for children but no operating facilities. The history of this institution has been documented in two books and occasionally published and unpublished papers. Many of these accounts have been limited by time, focus on a particular subject, or overall reviews. The emergence of such a specialized facility in the middle of the 19th century during a time of medicine in its infancy, our country at war and the city of New York racked in poverty, disease, civil riots, and political corruption is a story not necessarily appreciated in our day. The vision of one little-known physician and the cooperation and support of a small group of prominent New Yorkers and philanthropists were responsible for the origin of this hospital and particularly for its survival in such troubled times when most small hospitals of this period lasted only for a few years. Fortunately, almost all of the original Annual Reports of the Board of Managers, photographs, manuscripts, personal records, and newspaper clippings have been saved. They are now being collected, preserved, catalogued, and displayed in the newly formed HSS Archives from which this material has been taken.

  16. 77 FR 69915 - New York Disaster Number NY-00130

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-21

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13365 and 13366] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4085-DR), dated 10/30... State of NEW YORK, dated 10/30/2012 is hereby amended to include the following areas as adversely...

  17. 77 FR 68195 - New York Disaster Number NY-00130

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-15

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13365 and 13366] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4085-DR), dated 10/30... State of NEW YORK, dated 10/30/2012 is hereby amended to include the following areas as adversely...

  18. 78 FR 7848 - New York Disaster Number NY-00130

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13365 and 13366] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4085-DR), dated 10/30... disaster declaration for the State of New York, dated 10/30/2012 is hereby amended to extend the deadline...

  19. 76 FR 59176 - New York Disaster Number NY-00110

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-23

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12824 and 12825] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4031-DR), dated 09/13... disaster declaration for the State of New York, dated 09/13/2011 is hereby amended to include the following...

  20. 76 FR 18289 - New York Disaster Number NY-00102

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-01

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12479 and 12480] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... organizations in the State of New York, dated 02/18/2011, is hereby amended to include the following areas as...

  1. 76 FR 56856 - New York Disaster Number NY-00108

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12776 and 12777] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4020-DR), dated 08/31... State of New York, dated 08/31/2011 is hereby amended to include the following areas as adversely...

  2. 76 FR 68804 - New York Disaster Number NY-00110

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-07

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12824 and 12825] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4031-DR), dated 09/13... major disaster declaration for the State of New York, dated 09/13/2011 is hereby amended to extend the...

  3. 78 FR 15109 - New York Disaster Number NY-00130

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-08

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13365 and 13366] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4085-DR), dated 10/30... major disaster declaration for the State of New York, dated 10/30/2012 is hereby amended to extend the...

  4. 76 FR 61130 - New York Disaster Number NY-00110

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12824 and 12825] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4031-DR), dated 09/13... major disaster declaration for the State of New York, dated 09/13/2011 is hereby amended to establish...

  5. 76 FR 64420 - NEW YORK Disaster Number NY-00110

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-18

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12824 and 12825] NEW YORK Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4031-DR), dated 09/13... disaster declaration for the State of NEW YORK, dated 09/13/2011 is hereby amended to include the following...

  6. 76 FR 63700 - New York Disaster Number NY-00110

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12824 and 12825] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4031-DR), dated 09/13... disaster declaration for the State of New York, dated 09/13/2011 is hereby amended to include the following...

  7. 76 FR 60512 - New York; Emergency and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-29

    .... FEMA-3328-EM; Docket ID FEMA-2011-0001] New York; Emergency and Related Determinations AGENCY: Federal... of an emergency for the State of New York (FEMA-3328-EM), dated August 26, 2011, and related...: I have determined that the emergency conditions in certain areas of the State of New York resulting...

  8. 76 FR 56852 - New York Disaster Number NY-00108

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12776 and 12777] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4020-DR), dated 08/31... major disaster declaration for the State of New York, dated 08/31/2011 is hereby amended to establish...

  9. 77 FR 68797 - New York; Emergency and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-16

    .... FEMA-3351-EM; Docket ID FEMA-2012-0002] New York; Emergency and Related Determinations AGENCY: Federal... of an emergency for the State of New York (FEMA-3351-EM), dated October 28, 2012, and related... determined that the emergency conditions in the State of New York resulting from Hurricane Sandy beginning on...

  10. 76 FR 67245 - New York Disaster Number NY-00110

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-31

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12824 and 12825] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4031-DR), dated 09/13... disaster declaration for the State of New York, dated 09/13/2011 is hereby amended to include the following...

  11. 76 FR 61727 - New York; Emergency and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    .... FEMA-3341-EM; Docket ID FEMA-2011-0001] New York; Emergency and Related Determinations AGENCY: Federal... of an emergency for the State of New York (FEMA-3341-EM), dated September 8, 2011, and related...: I have determined that the emergency conditions in certain areas of the State of New York resulting...

  12. 76 FR 68803 - New York Disaster Number NY-00108

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-07

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12776 and 12777] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4020-DR), dated 08/31... disaster declaration for the State of New York, dated 08/31/2011 is hereby amended to extend the deadline...

  13. 77 FR 74907 - New York Disaster Number NY-00130

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-18

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13365 and 13366] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4085-DR), dated 10/30... disaster declaration for the State of New York, dated 10/30/2012 is hereby amended to extend the deadline...

  14. 76 FR 56857 - New York Disaster Number NY-00108

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12776 and 12777] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4020-DR), dated08/31... State of New York, dated 08/31/2011 is hereby amended to include the following areas as adversely...

  15. 76 FR 13698 - New York Disaster Number NY-00102

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-14

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12479 and 12480] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... organizations in the State of New York, dated 02/18/2011, is hereby amended to include the following areas as...

  16. 78 FR 20370 - New York Disaster Number NY-00130

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-04

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13365 and 13366] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4085-DR), dated 10/30... Disaster Declaration For The State Of New York, dated 10/30/2012 is hereby amended to extend the deadline...

  17. New York City's Children First: Lessons in School Reform

    ERIC Educational Resources Information Center

    Kelleher, Maureen

    2014-01-01

    Under Mayor Michael Bloomberg, New York City's education system embarked on a massive change effort, known as Children First, that produced significant results: new and better school options for families, more college-ready graduates, and renewed public confidence in New York City's schools. New York City's reform effort has also produced…

  18. Template Matching for Auditing Hospital Cost and Quality

    PubMed Central

    Silber, Jeffrey H; Rosenbaum, Paul R; Ross, Richard N; Ludwig, Justin M; Wang, Wei; Niknam, Bijan A; Mukherjee, Nabanita; Saynisch, Philip A; Even-Shoshan, Orit; Kelz, Rachel R; Fleisher, Lee A

    2014-01-01

    Objective Develop an improved method for auditing hospital cost and quality. Data Sources/Setting Medicare claims in general, gynecologic and urologic surgery, and orthopedics from Illinois, Texas, and New York between 2004 and 2006. Study Design A template of 300 representative patients was constructed and then used to match 300 patients at hospitals that had a minimum of 500 patients over a 3-year study period. Data Collection/Extraction Methods From each of 217 hospitals we chose 300 patients most resembling the template using multivariate matching. Principal Findings The matching algorithm found close matches on procedures and patient characteristics, far more balanced than measured covariates would be in a randomized clinical trial. These matched samples displayed little to no differences across hospitals in common patient characteristics yet found large and statistically significant hospital variation in mortality, complications, failure-to-rescue, readmissions, length of stay, ICU days, cost, and surgical procedure length. Similar patients at different hospitals had substantially different outcomes. Conclusion The template-matched sample can produce fair, directly standardized audits that evaluate hospitals on patients with similar characteristics, thereby making benchmarking more believable. Through examining matched samples of individual patients, administrators can better detect poor performance at their hospitals and better understand why these problems are occurring. PMID:24588413

  19. Template matching for auditing hospital cost and quality.

    PubMed

    Silber, Jeffrey H; Rosenbaum, Paul R; Ross, Richard N; Ludwig, Justin M; Wang, Wei; Niknam, Bijan A; Mukherjee, Nabanita; Saynisch, Philip A; Even-Shoshan, Orit; Kelz, Rachel R; Fleisher, Lee A

    2014-10-01

    Develop an improved method for auditing hospital cost and quality. Medicare claims in general, gynecologic and urologic surgery, and orthopedics from Illinois, Texas, and New York between 2004 and 2006. A template of 300 representative patients was constructed and then used to match 300 patients at hospitals that had a minimum of 500 patients over a 3-year study period. From each of 217 hospitals we chose 300 patients most resembling the template using multivariate matching. The matching algorithm found close matches on procedures and patient characteristics, far more balanced than measured covariates would be in a randomized clinical trial. These matched samples displayed little to no differences across hospitals in common patient characteristics yet found large and statistically significant hospital variation in mortality, complications, failure-to-rescue, readmissions, length of stay, ICU days, cost, and surgical procedure length. Similar patients at different hospitals had substantially different outcomes. The template-matched sample can produce fair, directly standardized audits that evaluate hospitals on patients with similar characteristics, thereby making benchmarking more believable. Through examining matched samples of individual patients, administrators can better detect poor performance at their hospitals and better understand why these problems are occurring. © Health Research and Educational Trust.

  20. 76 FR 59766 - New York Disaster Number NY-00110

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12824 and 12825] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4031-DR), dated 09/13... declaration for the State of New York, dated 09/13/2011 is hereby amended to include the following areas as...

  1. 77 FR 71666 - New York Disaster Number NY-00130

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-03

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13365 and 13366] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4085-DR), dated 10/30... declaration for the State of New York, dated 10/30/2012 is hereby amended to establish the incident period for...

  2. 76 FR 20524 - Anchorage Regulations; Port of New York

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-13

    ...-AA01 Anchorage Regulations; Port of New York AGENCY: Coast Guard, DHS. ACTION: Final rule. SUMMARY: The... Yunker, Coast Guard Sector New York, Waterways Management Division; telephone 718-354-4195, e-mail Jeff.M... New York in the Federal Register (74 FR 47906). We received one comment on the NPRM. No public meeting...

  3. 76 FR 59178 - New York Disaster Number NY-00108

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-23

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12776 and 12777] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4020-DR), dated 08/31... declaration for the State of New York, dated 08/31/2011 is hereby amended to include the following areas as...

  4. 76 FR 58328 - New York Disaster Number NY-00108

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-20

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12776 and 12777] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4020-DR), dated 08/31... declaration for the State of New York, dated 08/31/2011 is hereby amended to include the following areas as...

  5. 76 FR 58329 - New York Disaster Number NY-00108

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-20

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12776 and 12777] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4020-DR), dated 08/31... declaration for the State of NEW YORK, dated 08/31/2011, is hereby amended to include the following areas as...

  6. New York State technical economic MAGLEV evaluation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1991-06-01

    The Energy Authority, the New York State Departments of Transportation, Economic Development, Environmental Conservation and the New York State Thruway Authority sponsored an evaluation of high-speed surface transit options for New York State. This study is the preliminary evaluation of magnetically levitated ground transportation systems (MAGLEV). The evaluation focuses on using the New York State Thruway right-of-way in combination with MAGLEV systems currently in development in Germany and Japan and those proposed for development in the United States. The Energy Authority's goal in cosponsoring this study was to determine if MAGLEV offered the potential to meet future New York Statemore » transportation demands cost-effectively, and to evaluate the benefits that the State might expect from supporting MAGLEV technology development and system implementation. According to the preliminary report, substantial economic benefits could accrue to the State through MAGLEV-related research, development, manufacturing and construction. Implementation would have a favorable impact on issues related to transportation, the environment and energy conservation. With the exception of the German Transrapid system, developing a domestic prototype MAGLEV vehicle would take seven to nine years; no insurmountable technical barriers are apparent. EMF shielding (electromagnetic fields) is, however a concern. 39 refs., 71 figs., 26 tabs.« less

  7. Substance Abuse and Hospitalization for Mood Disorder Among Medicaid Beneficiaries

    PubMed Central

    Akincigil, Ayse; Hoover, Donald R.; Walkup, James T.; Bilder, Scott; Crystal, Stephen

    2009-01-01

    Objectives. We compared the influence of substance abuse with that of other comorbidities (e.g., anxiety, HIV) among people with mood disorder (N = 129 524) to explore risk factors for psychiatric hospitalization and early readmission within 3 months of discharge. Methods. After linking Medicaid claims data in 5 states (California, Florida, New Jersey, New York, and Texas) to community-level information, we used logistic and Cox regression to examine hospitalization risk factors. Results. Twenty-four percent of beneficiaries with mood disorder were hospitalized. Of these, 24% were rehospitalized after discharge. Those with comorbid substance abuse accounted for 36% of all baseline hospitalizations and half of all readmissions. Conclusions. Results highlight the need for increased and sustained funding for the treatment of comorbid substance abuse and mood disorder, and for enhanced partnership between mental health and substance abuse professionals. PMID:19008505

  8. A Visitor Control Policy for Martin Army Hospital,

    DTIC Science & Technology

    1978-04-05

    gathered at York Hospital resulted in the limitation of two visitors per patient at one time. This was not an arbitrary decision by management but...management is required to receive input from the consumer on many management decisions . Even discounting the above, the patient was felt to be a logical...proximity of the parking areas to the primary entrances, no additional staff entrances ,4 are needed, therefore no special locking devices for any auxillary

  9. Prehospital Indicators for Disaster Preparedness and Response: New York City Emergency Medical Services in Hurricane Sandy.

    PubMed

    Smith, Silas W; Braun, James; Portelli, Ian; Malik, Sidrah; Asaeda, Glenn; Lancet, Elizabeth; Wang, Binhuan; Hu, Ming; Lee, David C; Prezant, David J; Goldfrank, Lewis R

    2016-06-01

    We aimed to evaluate emergency medical services (EMS) data as disaster metrics and to assess stress in surrounding hospitals and a municipal network after the closure of Bellevue Hospital during Hurricane Sandy in 2012. We retrospectively reviewed EMS activity and call types within New York City's 911 computer-assisted dispatch database from January 1, 2011, to December 31, 2013. We evaluated EMS ambulance transports to individual hospitals during Bellevue's closure and incremental recovery from urgent care capacity, to freestanding emergency department (ED) capability, freestanding ED with 911-receiving designation, and return of inpatient services. A total of 2,877,087 patient transports were available for analysis; a total of 707,593 involved Manhattan hospitals. The 911 ambulance transports disproportionately increased at the 3 closest hospitals by 63.6%, 60.7%, and 37.2%. When Bellevue closed, transports to specific hospitals increased by 45% or more for the following call types: blunt traumatic injury, drugs and alcohol, cardiac conditions, difficulty breathing, "pedestrian struck," unconsciousness, altered mental status, and emotionally disturbed persons. EMS data identified hospitals with disproportionately increased patient loads after Hurricane Sandy. Loss of Bellevue, a public, safety net medical center, produced statistically significant increases in specific types of medical and trauma transports at surrounding hospitals. Focused redeployment of human, economic, and social capital across hospital systems may be required to expedite regional health care systems recovery. (Disaster Med Public Health Preparedness. 2016;10:333-343).

  10. [Clinical and molecular characteristics of hemoglobin New York in Guangxi populations].

    PubMed

    Li, You-qiong; Huang, Hui-pin; Yang, Wen-hui; Chen, Zhi-zhong; Zhao, Lin; Huang, Hua-yi; Qin, Gui-fang

    2013-08-01

    To analyze the clinical and molecular characteristics of hemoglobin New York in populations from Guangxi and provide reference data for screening thalassemia. A total of 30 691 samples were screened by capillary electrophoresis, and then suspicious samples of Hb New York were identified by DNA sequencing and analysis of blood cell count. Gap-PCR and reverse dot blot hybridization method were used for the detection of common mutations of α and β thalassemia in Chinese. The incidence of Hb New York was 0.12% in Guangxi. The hematological phenotype index (MCV, MCH, Hb New York, Hb A2) of 32 Hb New York heterozygous cases were (91.00±5.19)fl, (29.42±2.04)pg, (44.10±3.12)% and (2.80±0.29)% , respectively. The hematological phenotype index of 4 Hb New York composited SEA heterozygous patients were (68.20±5.26) fl, (21.78±2.15) pg, (36.60±2.00)% and (2.90±0.14)% , of 2 Hb New York composited WS heterozygous patients were (83.90±2.69) fl, (27.70±1.70) pg, (39.70±1.70)% and (3.50±0.21)%. There were statistical differences between three groups (P<0.05). HGB, MCV and MCH of Hb New York heterozygous and Hb New York composited WS heterozygous were normal, and patients with Hb New York composited SEA heterozygous showed mild anemia, decreased MCV and MCH. Most of Hb New York were heterozygous and no homozygotes in Guangxi. There were different hematological characteristics in different Hb New York heterozygous patients. Hb New York heterozygous had normal hematological phenotype, ant combined with other types of thalassemia could exhibit symptoms such as anemia.

  11. The timber resources of New York

    Treesearch

    George R. Armstrong; John C. Bjorkbom; John C. Bjorkbom

    1956-01-01

    This report presents the findings of the first comprehensive survey of the forests of New York, made in the period 1949 to 1952, by the Forest Service, U.S. Department of Agriculture, in cooperation with the New York Department of Conservation. The purposes of this survey were: (1) to make a field inventory of forest land and of the present supply of standing timber; (...

  12. New York City's Small Public Schools: Opportunities for Achievement.

    ERIC Educational Resources Information Center

    Brownell, Carol, Ed.; Libby, Joan

    In 1994, four New York City school reform organizations joined to form the New York Networks for School Renewal (NYNSR) and received the first Annenberg Challenge urban grant. NYNSR goals are to expand the number of small, excellent public schools in New York City neighborhoods, particularly those with few educational options; encourage the spread…

  13. State University of New York, University of Stoney Brook, University and Clinical Practice Management Plan Space Leasing Practices. Report 96-S-36.

    ERIC Educational Resources Information Center

    New York State Office of the Comptroller, Albany. Div. of Management Audit.

    This audit report assesses the propriety and economy of space leasing practices of the State University of New York at Stony Brook (SUNY-SB) for the period July 1, 1994 through December 31, 1996, specifically those related to a health center that includes five professional schools, a 536-bed teaching hospital, and a 350-bed veterans' home. Some of…

  14. New York City, Hudson River, NY, USA

    NASA Image and Video Library

    1991-05-06

    STS039-88-054 (28 April-6 May 1991) --- The dense urban development of the New York City metropolitan area in downstate New York, Long Island and New Jersey shows up as gray and white on this color Infrared photograph. The scene was taken on a remarkably clear spring day. Almost all the major man-made structures of the area are obvious, including ship traffic in and out of New York Harbor, the piers, all of the bridges spanning the area rivers and connecting Manhattan Island with New Jersey, the Bronx, Brooklyn and Queens, the three major airports (Newark, La Guardia and JFK), the New York State thruway, as well as Shea Stadium and Yankee Stadium. The reds and pinks are vegetated areas. Central Park clearly shows up on Manhattan, as do the string of parks along the cliffs (formed by the Palisades sill) along the west side of the Hudson north of the George Washington Bridge.

  15. The History of the Bellevue Hospital Chest Service (1903-2015).

    PubMed

    Rom, William N; Reibman, Joan

    2015-10-01

    For more than 100 years, the Bellevue Hospital Chest Service in New York City has contributed major advances in our understanding of pulmonary disease. Research from the cardiopulmonary laboratory of the Chest Service by Drs. Cournand and Richards resulted in the shared Nobel Prize in Physiology or Medicine in 1956 for the development of human cardiac catheterization. In more recent years, continuing its mission to serve the underserved and respond to health crises, the Bellevue Chest Service has served as a leader in the management of HIV infections, multiple drug-resistant tuberculosis epidemics, early detection of lung cancer, and management of urban asthma. Members of the Chest Service founded the World Trade Center Environmental Health Center shortly after collapse of the towers in 2001. The Chest Service became New York's infectious isolation unit caring for the first patient in New York infected with Ebola virus. Recent research has focused on disease management, with the first in-house Directly Observed Therapy Clinic for treatment of tuberculosis, clinical trials of aerosolized IFN-γ, and translational research on host defense against tuberculosis infection. Studies of the airway mucosa have revealed mechanisms by which ambient pollutants promote asthma. Studies on the World Trade Center firefighters and community populations have promoted understanding of systemic inflammation and small airways function. Today, the partnership between a public hospital and an academic institution promotes the synergy that leads to cost-effective and state-of-the art care for an underserved population as well as cutting-edge training and research.

  16. 46 CFR 15.1030 - New York and New Jersey.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false New York and New Jersey. 15.1030 Section 15.1030... REQUIREMENTS Vessels in Foreign Trade § 15.1030 New York and New Jersey. The following U.S. navigable waters located within the States of New York and New Jersey when the vessel is making an intra-port transit, to...

  17. El Idioma en Nueva York (The Language in New York)

    ERIC Educational Resources Information Center

    Hernandez, Amelia

    1977-01-01

    An interview with the president of the three-year-old Hispanic-American Journalists Association of New York. A summary of the aims and activities of the association and of the strides made in securing the rights of the Spanish-speaking population is given. (Text is in Spanish.) (AMH)

  18. Blood use in liver transplantation

    PubMed Central

    Lewis, J. H.; Bontempo, F. A.; Cornell, F.; Ki̋ss, J. E.; Larson, P.; Ragni, M. V.; Rice, E. O.; Spero, J. A.; Starzl, T. E.

    2010-01-01

    During the first 5 years (1981–1985) of the liver transplantation program in Pittsburgh, a total (preoperative, intraoperative, and postoperative) of 18,668 packed red cell units, 23,627 fresh-frozen plasma units, 20,590 platelet units, and 4241 cryoprecipitate units was transfused for the procedures. This represents 3 to 9 percent of the total of blood products supplied by the Central Blood Bank to its 32 member hospitals. Six hundred thirty-six (636) transplants were performed on 485 patients in two hospitals: the Presbyterian University Hospital (564 beds) and Children’s Hospital of Pittsburgh (236 beds). All of the blood components used in the operations were procured and released by the Central Blood Bank. This report describes some of these findings. PMID:3296340

  19. [The Importance of Hospital Hygiene: Findings of a German Nationwide Survey].

    PubMed

    Haking, Dennis

    2017-04-01

    Aim of the study: The German legislature reacted to the increasing number of nosocomial infections with a set of laws to strengthen hospital hygiene. The aim of the study is to measure the current and future importance of hospital hygiene in Germany. Methods: CEOs and hygiene staff from German hospitals took part in a survey on 13 items regarding the current and future importance of hospital hygiene. Statistical analyses were conducted to identify significances regarding the professional groups. Results: The results of the study show that hospital hygiene is currently of high importance and will be rising in the future. Hospital hygiene has a high economic impact, especially as a competitive factor. The patients' fear to suffer from a nosocomial infection, especially caused by multi-resistant bacteria, is countered with intensive educational work. Conclusion: The results demonstrate that the legislators' efforts are taken note of in German hospitals and the future strategic impact of hospital hygiene in a pay-for-performance reimbursement system has become clear. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Community School Board Elections in New York City. A Report to the New York State Commissioner of Education.

    ERIC Educational Resources Information Center

    Rubin, Max J.

    Following reports of irregularities in the May 1973 school board elections of New York City, the New York Commissioner of Education asked the author to identify the difficulties encountered by the voters and candidates, on both election day and in the period for registration and nomination which preceded it, and to recommend such changes in the…

  1. STS-135 New York City Visit

    NASA Image and Video Library

    2011-08-17

    New York Mayor Michael Bloomberg, center, talks about the construction around the site where the World Trade Center once stood to NASA Deputy Administrator Lori Garver, right, and members of the STS-135 crew including commander Chris Ferguson, left, mission specialist Rex Walheim, second right, and pilot Doug Hurley, rear, as they tour the area, Wednesday evening, Aug. 18, 2011, in New York. Photo Credit: (NASA/Paul E. Alers)

  2. 33 CFR 80.165 - New York Harbor.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false New York Harbor. 80.165 Section 80.165 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Atlantic Coast § 80.165 New York Harbor. A line drawn from East...

  3. A View from the New York Times.

    ERIC Educational Resources Information Center

    Richardson, Lynda; Quindlen, Anna

    1994-01-01

    Contains reprints of two articles from the New York Times: (1) Public Schools Are Failing Brightest Students, which discusses the Department of Education's recommendations for the gifted and talented and (2) Dumb About Smarts, which discusses problems of a New York City school for the gifted, Mott Hall School. (MKR)

  4. Determining binder flushing causes in New York state.

    DOT National Transportation Integrated Search

    2014-12-01

    In 2007, a number of asphalt pavements in New York State flushed. An extensive forensic and laboratory : investigation was conducted to determine why particular New York State asphalt pavements constructed in 2007 had : undergone atypical flush...

  5. Evaluation of New York state's mandatory occupant restraint law. Volume 2, Attitudinal surveys of licensed drivers in New York state

    DOT National Transportation Integrated Search

    1985-12-01

    This is the final report on the results of three attitudinal surveys of licensed drivers in New York state conducted as part of the evaluation of New York's Mandatory Occupant Restraint law. The objective of the attitudinal surveys was to provide inf...

  6. Data and Statistics on New York's Mining Resources - NYS Dept. of

    Science.gov Websites

    New York's Mining Resources Skip to main navigation Data and Statistics on New York's Mining Resources and review information about the regulated site. Materials Mined in New York- This site provides information on the various material mined in New York and the locations where they are extracted. Mined Land

  7. 75 FR 51506 - New York Disaster greek-iNY-00091

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-20

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12277 and 12278] New York Disaster NY-00091... Administrative declaration of a disaster for the State of NEW YORK dated 08/16/2010. Incident: Severe Storms and... disaster: Primary Counties: Cattaraugus. Contiguous Counties: New York: Allegany, Chautauqua, Erie, Wyoming...

  8. Working Together to Achieve Greater Impact: The Donors' Education Collaborative of New York City. Principles for Effective Education Grantmaking. Case Study Number 3

    ERIC Educational Resources Information Center

    Mackinnon, Anne

    2006-01-01

    The Donors' Education Collaborative of New York (DEC) began with a scene more typical of politics than philanthropy: five foundation presidents in a room, trying to figure out what to do for a city that had fallen on hard times in the early 1990s. They investigated specific topics--such as the public hospital system and school governance…

  9. STS-135 New York City Visit

    NASA Image and Video Library

    2011-08-16

    201108160008hq (16 Aug. 2011) --- Stephen Colbert, host of The Colbert Report, salutes the crew of STS-135, seated from lower left, NASA astronauts Chris Ferguson, commander; Doug Hurley, pilot; Sandy Magnus and Rex Walheim, both mission specialists, during their appearance for a taping of his television show, Aug. 16, 2011, in New York. The astronauts from STS-135 are in New York for a three-day visit. Photo credit: NASA/Paul E. Alers

  10. Building Business Awareness in Rural New York.

    ERIC Educational Resources Information Center

    Stevens, Jean; Drake, Robert; Huber, Candace; Powers, Betty; Reuland, Kris

    Half of New York State's 50 school-to-work (STW) programs are in rural areas. Following background on the development of New York's STW initiative, this paper describes four programs that are overcoming rural barriers to building an STW system. The GLOW Partnership addressed a primary concern of business partners: over-saturation of the limited…

  11. Effects of the August 2003 blackout on the New York City healthcare delivery system: a lesson for disaster preparedness.

    PubMed

    Prezant, David J; Clair, John; Belyaev, Stanislav; Alleyne, Dawn; Banauch, Gisela I; Davitt, Michelle; Vandervoorts, Kathy; Kelly, Kerry J; Currie, Brian; Kalkut, Gary

    2005-01-01

    On August 14, 2003, the United States and Canada suffered the largest power failure in history. We report the effects of this blackout on New York City's healthcare system by examining the following: 1) citywide 911 emergency medical service (EMS) calls and ambulance responses; and 2) emergency department (ED) visits and hospital admissions to one of New York City's largest hospitals. Citywide EMS calls and ambulance responses were categorized by 911 call type. Montefiore Medical Center (MMC) ED visits and hospital admissions were categorized by diagnosis and physician-reviewed for relationship to the blackout. Comparisons were made to the week pre- and postblackout. Citywide EMS calls numbered 5,299 on August 14, 2003, and 5,021 on August 15, 2003, a 58% increase (p < .001). During the blackout, there were increases in "respiratory" (189%; p < .001), "cardiac" (68%; p = .016), and "other" (40%; p < .001) EMS call categories, but when expressed as a percent of daily totals, "cardiac" was no longer significant. The MMC-ED reflected this surge with only "respiratory" visits significantly increased (expressed as percent of daily total visits; p < .001). Respiratory device failure (mechanical ventilators, positive pressure breathing assist devices, nebulizers, and oxygen compressors) was responsible for the greatest burden (65 MMC-ED visits, with 37 admissions) as compared with 0 pre- and postblackout. The blackout dramatically increased EMS and hospital activity, with unexpected increases resulting from respiratory device failures in community-based patients. Our findings suggest that current capacity to respond to public health emergencies could be easily overwhelmed by widespread/prolonged power failure(s). Disaster preparedness planning would be greatly enhanced if fully operational, backup power systems were mandated, not only for acute care facilities, but also for community-based patients dependent on electrically powered lifesaving devices.

  12. New York State

    NASA Image and Video Library

    2002-04-03

    On March 26, New York Mayor Michael Bloomberg declared a drought emergency for the city and four upstate counties in response to the worst drought to hit the eastern United States in nearly 70 years. Restrictions on water use will affect more than 8 million residents of New York. The city's reservoirs, located in the Catskill Mountains, are at 52 percent capacity. One of these, Ashokan Reservoir, is seen in this pair of ASTER images acquired on September 18, 2000 and February 3, 2002. These images were acquired by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite. With its 14spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER will image Earth for the next 6 years to map and monitor the changing surface of our planet. http://photojournal.jpl.nasa.gov/catalog/PIA03491

  13. Improving population health by reducing poverty: New York's Earned Income Tax Credit.

    PubMed

    Wicks-Lim, Jeannette; Arno, Peter S

    2017-12-01

    Despite the established relationship between adverse health outcomes and low socioeconomic status, researchers rarely test the link between health improvements and poverty-alleviating economic policies. New research, however, links individual-level health improvements to the Earned Income Tax Credit (EITC), a broad-based income support policy. We build on these findings by examining whether the EITC has ecological, neighborhood-level health effects. We use a difference-in-difference analysis to measure child health outcomes in 90 low- and middle- income neighborhoods before and after the expansion of New York State and New York City's EITC policy between 1997-2010. Our study takes advantage of the relatively exogenous source of income variation supplied by the EITC-legislative changes to EITC policy parameters. This feature minimizes the endogeneity problem in studying the relationship between income and health. Our estimates link a 15-percentage-point increase in EITC benefit rates to a 0.45 percentage-point reduction in the low birthweight rate. We do not observe any measurable link between EITC benefits and prenatal health or asthma-related pediatric hospitalization. The magnitude of the EITC's impact on low birthweight rates suggests ecological effects, and an additional channel through which anti-poverty measures can serve as public health interventions.

  14. 19th century pioneers of intensive therapy in North America. Part 2: Joseph O'Dwyer.

    PubMed

    Trubuhovich, Ronald V

    2008-06-01

    Dr Joseph O'Dwyer's principal distinction lies in his dedication and achievements in battling laryngeal diphtheria among children at the New York Foundling Asylum, where he was a physician from 1872. He was also active at the Presbyterian Hospital of New York and in private practice. Some of his pioneering work anticipated methods of intensive care medicine. His achievements included: * Introduction of a practical system of intralaryngeal intubation, including designs of tubes and a technique for inserting them, after many years of careful study and experimentation - always "without borrowed inspiration". * Use of his tubes in children with diphtheritic pseudomembranes in the larynx, to substantially increase their survival chances at a time when tracheotomy for this problem still had a high failure rate. The first intubated patient recovered, November 1882, only after change to prolonged wearing of a tracheotomy tube, so O'Dwyer did not date his first intubation success until 21 May 1884. * Introduction of his tubes into the Fell method of forced respiration, with the resultant Fell-O'Dwyer apparatus supplying practical instrumentation for intermittent positive pressure ventilation. * Demonstration that this apparatus, primarily used for saving lives after acute opiate poisoning, was also useful with some intracranial disasters, 1894. * Provision of a system, which others then applied, enabling surgeons to overcome the great "pneumothorax problem" of intrathoracic operations, and thereby conduct safe surgery inside the chest, 1898. * Development of an intubating method using successive short-term dilatations for treating chronic laryngeal stenosis, usually syphilitic, in adults, 1885. Throughout his medical lifetime, O'Dwyer was held in the highest regard as an altruistic, compassionate person of "sincere simplicity and frank goodness of character".

  15. A hospital-specific template for benchmarking its cost and quality.

    PubMed

    Silber, Jeffrey H; Rosenbaum, Paul R; Ross, Richard N; Ludwig, Justin M; Wang, Wei; Niknam, Bijan A; Saynisch, Philip A; Even-Shoshan, Orit; Kelz, Rachel R; Fleisher, Lee A

    2014-10-01

    Develop an improved method for auditing hospital cost and quality tailored to a specific hospital's patient population. Medicare claims in general, gynecologic and urologic surgery, and orthopedics from Illinois, New York, and Texas between 2004 and 2006. A template of 300 representative patients from a single index hospital was constructed and used to match 300 patients at 43 hospitals that had a minimum of 500 patients over a 3-year study period. From each of 43 hospitals we chose 300 patients most resembling the template using multivariate matching. We found close matches on procedures and patient characteristics, far more balanced than would be expected in a randomized trial. There were little to no differences between the index hospital's template and the 43 hospitals on most patient characteristics yet large and significant differences in mortality, failure-to-rescue, and cost. Matching can produce fair, directly standardized audits. From the perspective of the index hospital, "hospital-specific" template matching provides the fairness of direct standardization with the specific institutional relevance of indirect standardization. Using this approach, hospitals will be better able to examine their performance, and better determine why they are achieving the results they observe. © Health Research and Educational Trust.

  16. Hospital participation in Meaningful Use and racial disparities in readmissions.

    PubMed

    Unruh, Mark Aaron; Jung, Hye Young; Kaushal, Rainu; Vest, Joshua R

    2018-01-01

    To measure the impact of hospital participation in Meaningful Use (MU) on disparities in 30-day readmissions associated with race. A retrospective cohort study that compared the likelihood of 30-day readmission for Medicare beneficiaries discharged from hospitals participating in Stage 1 of MU with the likelihood of readmission for beneficiaries concurrently discharged from hospitals that were not participating in the initiative. Inpatient claims for 2,414,205 Medicare beneficiaries from Florida, New York, and Washington State were used as the primary data source. The study period (2009-2013) included at least 2 years of baseline data prior to each hospital initiating participation in MU. Estimates were derived with linear regression models that included hospital and time fixed effects. By including both hospital and time fixed effects, estimates were based on discharges from the same hospital in the same time period. MU participation among hospitals was not associated with a statistically significant change in readmissions for the broader Medicare population (percentage points [PP], 0.6; 95% CI, -0.2 to 1.4), but hospitals' participation in the initiative was associated with a lower likelihood of readmission for African American beneficiaries (PP, -0.9; 95% CI, -1.5 to -0.4). Hospital participation in MU reduced disparities in 30-day readmissions for African American Medicare beneficiaries.

  17. The forest-land owners of New York

    Treesearch

    Thomas W. Birch

    1983-01-01

    Information about the attitudes and objectives of the private forest-land owners is essential to understanding New York's forest resources. Ninety-four percent of New York's 15.4 million acres of commercial forest land is in 506,500 private ownerships. Eighty-nine percent of these ownerships are individual and joint ownerships. A majority, 66 percent of these...

  18. [Choice of Hospital for Childbirth in Switzerland: Decision Factors and Sources of Information].

    PubMed

    Wiedenhöfer, D; Keppler, S

    2017-06-01

    The introduction of Swiss DRG in 2012 offers women in Switzerland free choice of hospital. The objective of this study was to identify decision factors affecting the choice of hospital birth in Switzerland and to rate the degree of utilization of information sources. In seven Swiss hospitals, located in the German-speaking part of Switzerland, women in childbed were interviewed in writing. When choosing a hospital, factors rated by women as important were professional competence, good medical care, good obstetric competence, good nursing care and a neat and clean atmosphere. Important sources of information are recommendations of friends, own experience gained during previous hospital stays, the specialist, family, and the hospital homepage. Information meetings for pregnant women are essential for hospitals because they encourage women's decision to use the hospital. Web presence of the hospital and a good relationship with the specialists or family doctors are important, but experience of friends, family or one's own experience with stay at the hospital play a more important role. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Impact of State hospital rate setting on capital formation

    PubMed Central

    Cromwell, Jerry

    1987-01-01

    For this article, a new national data base of Medicare cost reports on more than 2,000 hospitals is used to measure the impact of State prospective rate setting on capital formation. Several investment measures are analyzed, both in nominal and real terms, using a combination of descriptive and multivariate techniques. Results indicate that, over the last decade, State hospital rate-setting programs have had little demonstrable effect on capital formation and they have not caused any significant aging of plant assets. Programs in both New York and Massachusetts were found to be associated with a slowing in the rate of bed growth, however, resulting in significant long-term cost savings. PMID:10312117

  20. Alternative Fuels Data Center: New York Transportation Data for Alternative

    Science.gov Websites

    Fuels and Vehicles New York Transportation Data for Alternative Fuels and Vehicles to someone by E-mail Share Alternative Fuels Data Center: New York Transportation Data for Alternative Fuels and Vehicles on Facebook Tweet about Alternative Fuels Data Center: New York Transportation Data for

  1. Alternative Fuels Data Center: New York Coalition Helps Local Alternative

    Science.gov Websites

    Fuel Station Boost Revenue New York Coalition Helps Local Alternative Fuel Station Boost Revenue to someone by E-mail Share Alternative Fuels Data Center: New York Coalition Helps Local Alternative Fuel Station Boost Revenue on Facebook Tweet about Alternative Fuels Data Center: New York

  2. 78 FR 60009 - Environmental Impact Statement: Erie and Genesee Counties, New York

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-30

    ... and Genesee Counties, New York AGENCY: Federal Highway Administration (FHWA), DOT; New York State... counties of Erie and Genesee, New York (NYSDOT Project Identification Number: 5528.28). A Notice of Intent... CONTACT: Jonathan McDade, Division Administrator, Federal Highway Administration, New York Division, Leo W...

  3. Selected Papers from the 1982 Conference "New York Writes: Kindergarten through College" (New York, New York, April 3, 1982).

    ERIC Educational Resources Information Center

    Kwalick, Barry, Ed.; And Others

    Presenting sound instructional strategies and writing theories, these proceedings of a conference held at Marymount Manhattan College address the needs of writing teachers at all educational levels. Following an introduction outlining the conference and the "New York Writes" project, the keynote address discusses the renewed interest in…

  4. Management of sexually transmitted infections in New York State health care organizations: who is thinking about the quality of STI care?

    PubMed

    Janowski, John Patrick B; Garrett, William S; Feller, Daniel J; Hathaway, Rebecca; Kushner, John; Pelish, Matthew; Agins, Bruce D

    2014-09-01

    Rising rates of sexually transmitted infections (STIs) warrant a renewed focus on the management of STIs in health care organizations. The extent to which hospitals and community health centers (CHCs) have established processes and allocated staff for the management of STIs within their organizations remains poorly understood. A New York State Department of Health survey was distributed electronically through a closed state communication network to targeted administrators at New York State hospitals and CHCs. The survey asked if STI management in their facilities included the following: the ability to measure and report rates of STIs, a process to assess the quality of STI care and treatment outcomes, and a centralized person/unit to coordinate its work throughout the facility. Multivariate analysis was performed to identify whether organizational characteristics were associated with survey findings. Ninety-five percent (243/256) of hospitals and CHCs responded to the survey. Fifty percent of respondents had a person or unit to report rates of STIs; 30% reported an organization-wide process for monitoring the quality of STI care, which, according to the multivariate analysis, was associated with CHCs; only 23% reported having a centralized person or unit for coordinating STI management. Most facilities report STI cases to comply with public health surveillance requirements but do not measure infection rates, assess the quality of STI care, or coordinate its work throughout the facility. The development of this organizational capacity would likely decrease STI rates, improve treatment outcomes, and address local public health goals.

  5. Colorectal Surgery Fellowship Improves In-hospital Mortality After Colectomy and Proctectomy Irrespective of Hospital and Surgeon Volume.

    PubMed

    Saraidaridis, Julia T; Hashimoto, Daniel A; Chang, David C; Bordeianou, Liliana G; Kunitake, Hiroko

    2018-03-01

    General surgery residents are increasingly pursuing sub-specialty training in colorectal (CR) surgery. However, the majority of operations performed by CR surgeons are also performed by general surgeons. This study aimed to assess in-hospital mortality stratified by CR training status after adjusting for surgeon and hospital volume. The Statewide Planning and Research Cooperative system database was used to identify all patients who underwent colectomy/proctectomy from January 1, 2000, to December 31, 2014, in the state of New York. Operations performed by board-certified CR surgeons were identified. The relationships between CR board certification and in-hospital mortality, in-hospital complications, length of stay, and ostomy were assessed using multivariate regression models. Two hundred seventy thousand six hundred eighty-four patients underwent colectomy/proctectomy over the study period. Seventy-two thousand two hundred seventy-nine (26.7%) of operations were performed by CR surgeons. Without adjusting for hospital and surgeon volume, in-hospital mortality was lower for those undergoing colectomy/proctectomy by a CR surgeon (OR 0.49, CI 0.44-0.54, p = 0.001). After controlling for hospital and surgeon volume, the odds of inpatient mortality after colectomy/proctectomy for those operated on by CR surgeons weakened to 0.76 (CI 0.68-0.86, p = 0.001). Hospital and surgeon volume accounted for 53% of the reduction in in-hospital mortality when CR surgeons performed colectomy/proctectomy. Patients who underwent surgery by a CR surgeon had a shorter inpatient stay (0.8 days, p = 0.001) and a decreased chance of colostomy (OR 0.86, CI 0.78-0.95, p < 0.001). For patients undergoing colectomy/proctectomy, in-hospital mortality decreased when the operation was performed by a CR surgeon even after accounting for hospital and surgeon volume.

  6. 77 FR 69647 - New York; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-20

    .... FEMA-4085-DR; Docket ID FEMA-2012-0002] New York; Major Disaster and Related Determinations AGENCY... declaration of a major disaster for the State of New York (FEMA-4085-DR), dated October 30, 2012, and related... have determined that the damage in certain areas of the State of New York resulting from Hurricane...

  7. 33 CFR 110.60 - Captain of the Port, New York.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Captain of the Port, New York... ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.60 Captain of the Port, New York. (a) Western... point of origin. (d) New York Harbor. (1) Newark Bay, Southeast. All waters bound by the following...

  8. 76 FR 61731 - New York; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    .... FEMA-4020-DR; Docket ID FEMA-2011-0001] New York; Major Disaster and Related Determinations AGENCY... declaration of a major disaster for the State of New York (FEMA-4020-DR), dated August 31, 2011, and related... have determined that the damage in certain areas of the State of New York resulting from Hurricane...

  9. Perspectives 1989 [on Library Service Developments in New York State].

    ERIC Educational Resources Information Center

    The Bookmark, 1989

    1989-01-01

    The 10 articles in this theme issue provide 1989 prespectives on several library service developments in New York State and on the work that preceded them: (1) "Library Systems in New York State: Opportunity for Greater Service" (Statement by the Board of Regents, September 1989); (2) "King Research Report Evaluates New York's…

  10. New York State's COSH Movement: A Brief History.

    PubMed

    Lax, Michael

    2018-01-01

    Unions, health and safety activists, and professionals came together to create Coalitions for Occupational Safety and Health (COSH groups) in a number of cities across the United States beginning in the 1970s. The COSHes have played an important and unique role in advocating worker health and safety since that time, through activities including technical assistance, training and education, and campaigns on workplace and public policies. In New York State, activist coalitions created eight COSH groups distributed around the state. This paper presents a history of New York's COSHes based on interviews with key participants. The interviews shed light on the origins of the COSH movement in New York, the development and activities of the COSHes, and the organizational trajectory of individual New York COSHes in response to both extra and intraorganizational challenges. Participants' accounts of these issues may be useful for those seeking to sustain the COSH movement.

  11. The Rural Obstetric Workforce in US Hospitals: Challenges and Opportunities

    PubMed Central

    Kozhimannil, Katy B.; Casey, Michelle M.; Hung, Peiyin; Han, Xinxin; Prasad, Shailendra; Moscovice, Ira S.

    2015-01-01

    Purpose The purpose of this study was to describe the types and combinations of clinicians who are delivering babies in rural hospitals, their employment status, the relationship between hospital birth volume and staffing models, and the staffing challenges faced by rural hospitals. Methods We conducted a telephone survey of 306 rural hospitals in 9 states: Colorado, Iowa, Kentucky, New York, North Carolina, Oregon, Vermont, Washington, and Wisconsin, from November 2013-March 2014 to assess their obstetric workforce. Bivariate associations between hospitals’ annual birth volume and obstetric workforce characteristics were examined, as well as qualitative analysis of workforce changes and staffing challenges. Findings Hospitals with lower birth volume (< 240 births per year) are more likely to have family physicians and general surgeons attending deliveries, while those with a higher birth volume more frequently have obstetricians and midwives attending deliveries. Reported staffing challenges include scheduling, training, census fluctuation, recruitment and retention, and intra-hospital relationships. Conclusions Individual hospitals working in isolation may struggle to address staffing challenges. Federal and state policy makers, regional collaboratives, and health care delivery systems can facilitate solutions through programs such as telehealth, simulation training, and interprofessional education. PMID:25808202

  12. Wilms' tumor in New York State: epidemiology and survivorship.

    PubMed

    Griffel, M

    1977-12-01

    The outcomes during the period 1950--1972 were compared for Wilms' tumor patients in Erie County, New York (Buffalo and environs) and in a random selection of 23 counties having much smaller populations. For the Erie cohorts of 1967 to 1972 an 87 per cent 7-year survival rate was found as compared with a 50 per cent survival for the corresponding cohorts of the less populous couties. For the years 1960--1966 the 5-year survival rates were respectively 67 and 25 per cent and for the decade 1950--1959, 26 and 23 per cent. The principal conclusion is that within the last 15 years the Erie residents have fared better than residents of the smaller counties. The difference is attributed to the better treatment and care available at some of the hospitals in Buffalo. Data on incidence, age at diagnosis, male/female ratio, and laterality are presented.

  13. Factors influencing the use of registered nurse overtime in hospitals, 1995-2000.

    PubMed

    Berney, Barbara; Needleman, Jack; Kovner, Christine

    2005-01-01

    To assess nurse overtime in acute care general hospitals and the factors that influence overtime among various hospitals and in the same hospitals from year to year. Staffing data from 1995 to 2000 from 193 acute general hospitals in New York State were used to examine hospital characteristics (size, location, RN unionization, hospital ownership, and teaching status) to determine whether they were associated with nurse overtime. The average weekly overtime RNs worked was 4.5% of total hours, varying from almost none to 16.6%. At mean overtime levels, nurses were working less overtime than the mean for manufacturing workers, but, at the extreme, nurses were working more than 6 hours overtime per week. Significant differences were observed in the use of overtime by hospital ownership and by union status. Nurses in government hospitals worked less overtime than did those in nongovernment hospitals. Nurses in unionized hospitals worked slightly more overtime than did nurses in nonunionized hospitals. Hospitals varied dramatically in their overtime use. That some categories of hospitals (e.g., government-owned) used little overtime indicates that hospital management can find substitutes for overtime to meet fluctuating staffing needs. The finding that hospitals with similar characteristics varied greatly in their number of overtime hours also supported this conclusion.

  14. Patient evaluation of the hotel function of hospitals.

    PubMed

    Oz, M C; Zikria, J; Mutrie, C; Slater, J P; Scott, C; Lehman, S; Connolly, M W; Asher, D T; Ting, W; Namerow, P B

    2001-01-01

    A means of measuring patient satisfaction is essential in the effort to improve the quality of health care delivered in our nation's hospitals. Accurate feedback allows employers to better meet patients' needs and allows hospital administrators to improve service delivery. Patients are empowered by having a voice in the manner in which their health care is delivered. Moreover, improving the efficiency of the health care delivery system decreases health care costs. Hospital comparisons can be made readily available to a large audience through the Internet, resulting in empowerment of the patient and a universal improvement in hospital care. This is the first multi-institutional analysis of patient satisfaction among New York City and northern New Jersey area tertiary care hospitals. In this study, we evaluated the patient-assessed hotel function of hospitals in a single geographic region to determine whether clinically and statistically significant differences would be revealed that could provide beneficial information to stakeholders in the healthcare system. Patients (n = 261) who had spent a night during the past year in one of eleven hospitals within 60 miles of New York City were chosen at random from doctors' waiting rooms. On average, 24 patients from each hospital were surveyed. They were asked to complete a questionnaire that rated the various departments in the hospital on qualities such as courtesy, promptness, and cleanliness. The questionnaire also rated important characteristics of the patient experience, such as the ease of parking and the taste of the food. Each item on the survey was coded on a scale of 1 to 10 with 10 being the most positive response. The 26 specific questions were divided into 14 domains. Averages in each domain were compared by gender, age, and hospital identity, attractiveness, and setting. All statistical calculations were performed using SPSS/PC, and means were compared using t-tests. Analysis designed to evaluate outcomes

  15. 76 FR 44347 - New York; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-25

    .... FEMA-1993-DR; Docket ID FEMA-2011-0001] New York; Major Disaster and Related Determinations AGENCY... declaration of a major disaster for the State of New York (FEMA-1993-DR), dated June 10, 2011, and related... determined that the damage in certain areas of the State of New York resulting from severe storms, flooding...

  16. 75 FR 65501 - New York; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-25

    .... FEMA-1943-DR; Docket ID FEMA-2010-0002] New York; Major Disaster and Related Determinations AGENCY... declaration of a major disaster for the State of New York (FEMA-1943-DR), dated October 14, 2010, and related... have determined that the damage in certain areas of the State of New York resulting from severe storms...

  17. 78 FR 27414 - New York; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-10

    .... FEMA-4111-DR; Docket ID FEMA-2013-0001] New York; Major Disaster and Related Determinations AGENCY... declaration of a major disaster for the State of New York (FEMA-4111-DR), dated April 23, 2013, and related... Act''), as follows: I have determined that the damage in certain areas of the State of New York...

  18. 76 FR 12362 - New York; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-07

    .... FEMA-1957-DR; Docket ID FEMA-2011-0001] New York; Major Disaster and Related Determinations AGENCY... declaration of a major disaster for the State of New York (FEMA-1957-DR), dated February 18, 2011, and related... Act''), as follows :I have determined that the damage in certain areas of the State of New York...

  19. 78 FR 45549 - New York; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-29

    .... FEMA-4129-DR; Docket ID FEMA-2013-0001] New York; Major Disaster and Related Determinations AGENCY... declaration of a major disaster for the State of New York (FEMA-4129-DR), dated July 12, 2013, and related... determined that the damage in certain areas of the State of New York resulting from severe storms and...

  20. 75 FR 22610 - New York; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-29

    .... FEMA-1899-DR; Docket ID FEMA-2010-0002] New York; Major Disaster and Related Determinations AGENCY... declaration of a major disaster for the State of New York (FEMA-1899-DR), dated April 16, 2010, and related... in certain areas of the State of New York resulting from severe storms and flooding during the period...

  1. 33 CFR 161.25 - Vessel Traffic Service New York Area.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Vessel Traffic Service New York... Movement Reporting System Areas and Reporting Points § 161.25 Vessel Traffic Service New York Area. The area consists of the navigable waters of the Lower New York Harbor bounded on the east by a line drawn...

  2. Alternative Fuels Data Center: New York Broadens Network for Electric

    Science.gov Websites

    Vehicle Charging New York Broadens Network for Electric Vehicle Charging to someone by E-mail Share Alternative Fuels Data Center: New York Broadens Network for Electric Vehicle Charging on Facebook Tweet about Alternative Fuels Data Center: New York Broadens Network for Electric Vehicle Charging on

  3. A Gateway to Health Careers for Urban High School Students: Collaborative Front-Line and Allied Workforce Development Program among High Schools, Public Hospitals and Public Colleges. Program Results Report

    ERIC Educational Resources Information Center

    Jablow, Paul

    2012-01-01

    From 2005 to 2011, the Gateway Institute for Pre-College Education partnered with three public entities in New York City--the Department of Education, the City University of New York and the Health and Hospitals Corporation--to introduce, educate, and prepare urban high school students for careers in the health professions. Gateway was launched in…

  4. Carbon monoxide exposures in New York City following Hurricane Sandy in 2012.

    PubMed

    Chen, B C; Shawn, L K; Connors, N J; Wheeler, K; Williams, N; Hoffman, R S; Matte, T D; Smith, S W

    2013-11-01

    On October 29, 2012, Hurricane Sandy made landfall and devastated New York's metropolitan area, causing widespread damage to homes and the utility infrastructure. Eight days later, snow and freezing temperatures from a nor'easter storm delayed utility restoration. To examine carbon monoxide (CO) exposures in the 2 weeks following Hurricane Sandy. Methods. This was a retrospective review of prospectively collected, standardized, and de-identified data sets. CO exposures and poisonings identified from two electronic surveillance systems, the New York City Poison Control Center (NYCPCC) and New York City's Syndromic Surveillance Unit, were compared with CO exposures from identical dates in 2008-2011. Data collected from the poison center included exposure type, CO source, poisoning type, treatment, and outcomes. Data collected from the Syndromic Surveillance Unit cases, which were identified by CO-related chief complaints presenting to NYC hospitals, included visit date and time, and patient demographics. Four hundred thirty-seven CO exposures were reported to the NYCPCC, 355 from NYC callers, and the remainder from surrounding counties, which represented a significant increase when compared with CO exposures from identical dates in the preceding 4 years (p < 0.001). The total cases that were reported to the NYCPCC in 2008, 2009, 2010, and 2011 were 18, 13, 24, and 61, respectively. Excluding a single apartment fire that occurred (n = 311), the more common sources of CO were grilling indoors (26.2%) and generators (17.5%). Syndromic surveillance captured 70 cases; 6 cases were captured by both data sets. CO exposures following weather-related disasters are a significant public health concern, and the use of fuel-burning equipment is a clear source of storm-related morbidity and mortality. Multiple real-time epidemiologic surveillance tools are useful in estimating the prevalence of CO exposure and poisoning and are necessary to assist public health efforts to prevent

  5. ["Lex Kendra" in New York, United States. Homicide, "revolving door psychiatry" and political response].

    PubMed

    Röttgers, H R; Nedjat, S

    2001-03-01

    The history, motivation and consequences of the New York State "Kendra's Law" as of August 1999 are reviewed. "Kendra's Law" was the consequence of the killing of a young woman, Kendra W., by a schizophrenic patient later convicted for second degree murder. Before, he had been repeatedly rejected when he sought treatment in state-run psychiatric facilities and was expelled several times from long-term hospitals despite a long history of violent behaviour when untreated. "Kendra's Law" now entitles physicians, case workers, roommates and families of untreated mentally ill persons to seek a court order forcing a patient to comply with treatment and, at the same time, compelling mental health institutions to grant this treatment. Additionally, the law and another bill signed in November 1999 provided for additional funding for the underfinanced state-run mental health system. "Kendra's Law" illustrates a bidirectional attempt to cope with the revolving door treatment situation of mentally ill in the State of New York by additional funding and additional possibilities to enforce treatment. The law illustrates the fundamental conflict between individual autonomy and the need for treatment of people suffering from severe mental illness.

  6. Access to hospitals with high-technology cardiac services: how is race important?

    PubMed Central

    Blustein, J; Weitzman, B C

    1995-01-01

    OBJECTIVES. Relatively few hospitals in the United States offer high-technology cardiac services (cardiac catheterization, bypass surgery, or angioplasty). This study examined the association between race and admission to a hospital offering those services. METHODS. Records of 11,410 patients admitted with acute myocardial infarction to hospitals in New York State in 1986 were analyzed. RESULTS. Approximately one third of both White and Black patients presented to hospitals offering high-technology cardiac services. However, in a multivariate model adjusting for home-to-hospital distance, the White-to-Black odds ratio for likelihood of presentation to such a hospital was 1.68 (95% confidence interval = 1.42, 1.98). This discrepancy between the observed and "distance-adjusted" probabilities reflected three phenomena: (1) patients presented to nearby hospitals; (2) Blacks were more likely to live near high-technology hospitals; and (3) there were racial differences in travel patterns. For example, when the nearest hospitals did not include a high-technology hospital, Whites were more likely than Blacks to travel beyond those nearest hospitals to a high-technology hospital. CONCLUSIONS. Whites and Blacks present equally to hospitals offering high-technology cardiac services at the time of acute myocardial infarction. However, there are important underlying racial differences in geographic proximity and tendencies to travel to those hospitals. PMID:7892917

  7. Home Page: NYS Government Information Locator Service: New York State

    Science.gov Websites

    Constitution external link - from the New York State Department of State NYS Judicial System (NYS Unified Courts System) Unified Court System external link - the main resource for information about New York's decisions of the New York courts in the Official Reports. The searchable Legal Research Portal external link

  8. New York's TUNDRA.

    ERIC Educational Resources Information Center

    Kalinowski, Thomas

    1983-01-01

    Found at the summit of some of the highest peaks of New York State's Adirondack Mountains are low-growing plants similar, and in many cases, identical to plants growing in the Arctic. Describes these plants and the environment in which they are found. Includes a color plate of alpine tundra plants. (Author/JN)

  9. 76 FR 59177 - New York Disaster #NY-00110

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-23

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12824 and 12825] New York Disaster NY-00110... declaration of a major disaster for the State of New York (FEMA-4031-DR), dated 09/13/2011. Incident: Remnants... Loans): Broome, Chenango, Delaware, Otsego, Tioga. Contiguous Counties (Economic Injury Loans Only): New...

  10. 77 FR 64372 - New York Disaster #NY-00126

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13341 and 13342] New York Disaster NY-00126 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a notice of an Administrative declaration of a disaster for the State of New York dated 10/10/2012. Incident: Heavy Rain and...

  11. Residential proximity to large airports and potential health impacts in New York State.

    PubMed

    Lin, S; Munsie, J P; Herdt-Losavio, M; Hwang, S A; Civerolo, K; McGarry, K; Gentile, T

    2008-07-01

    This study assessed whether residents living near commercial airports have increased rates of hospital admissions due to respiratory diseases compared to those living farther away from these airports. This cross-sectional study included all residents living within 12 miles from the center of each three airports (Rochester in Rochester, LaGuardia in New York City and MacArthur in Long Island). We obtained hospital admission data collected by the NYS Department of Health for all eligible residents who were admitted for asthma, chronic bronchitis, emphysema, chronic obstructive pulmonary disease and, for children aged 0-4 years, bronchitis and bronchiolitis during 1995-2000. Exposure indicators were distance from the airport (< or =5 miles versus >5 miles) and dominant wind-flow patterns from the airport (>75th percentile versus < or =75th percentile), as well as their combinations. Increased relative risks of hospital admissions for respiratory conditions were found for residents living within 5 miles from the airports (1.47; 95% CI 1.41, 1.52 for Rochester and 1.38; 95% CI 1.37, 1.39 for LaGuardia) compared to those living >5 miles. We did not find positive associations between wind-flow patterns and respiratory hospital admissions among the residents in any airport vicinity. No differences were observed for MacArthur airport using either exposure measure. There is the suggestion that residential proximity to some airports may increase hospital admissions for respiratory disorders. However, there are many factors that could influence this association that may differ by airport, which should be measured and studied further.

  12. The New York State optometry workforce study.

    PubMed

    Soroka, Mort

    2012-04-01

    This study presents an analysis of the current optometry workforce, both as a unique profession and more broadly within the context of all eye care providers (optometry and ophthalmology) in New York State. The supply and distribution of eye care practitioners provides useful information for policy makers while providing insights as to the impact of the one optometry school within the state. Several databases were employed and a web based survey was developed for completion by all optometrists. The questionnaire included demographic data, whether they were actively practicing in New York State or any other state, were they full time or part time, their primary mode of practice, or if they provided care within institutional settings. Access to care was gauged by the respondents' availability for appointments during evenings or weekends. Access to eye care services in New York State has improved significantly during the past 30 years as the supply of optometrists increased. Before this study was conducted it was generally believed that there were more optometrists than ophthalmologists in every state of the nation except New York, Maryland and the District of Columbia. Findings of this study demonstrate there are 37% more optometrists in New York State than ophthalmologists and more evenly distributed as optometrists are located in almost every county of the state. Sixteen counties have no ophthalmologists. This is attributed to the presence of the College of Optometry established in 1971. More than 60% of all optometrists in the state are SUNY College of Optometry graduates.

  13. Black ash silviculture projects in New York and Maine

    Treesearch

    Michael R. Bridgen

    2010-01-01

    This paper reports the success of artificially establishing two black ash stands in northern New York using planted seedlings. Results of thinning projects in northern New York and Maine are also reported.

  14. Increased Rate of Hospitalization for Diabetes and Residential Proximity of Hazardous Waste Sites

    PubMed Central

    Kouznetsova, Maria; Huang, Xiaoyu; Ma, Jing; Lessner, Lawrence; Carpenter, David O.

    2007-01-01

    Background Epidemiologic studies suggest that there may be an association between environmental exposure to persistent organic pollutants (POPs) and diabetes. Objective The aim of this study was to test the hypothesis that residential proximity to POP-contaminated waste sites result in increased rates of hospitalization for diabetes. Methods We determined the number of hospitalized patients 25–74 years of age diagnosed with diabetes in New York State exclusive of New York City for the years 1993–2000. Descriptive statistics and negative binomial regression were used to compare diabetes hospitalization rates in individuals who resided in ZIP codes containing or abutting hazardous waste sites containing POPs (“POP” sites); ZIP codes containing hazardous waste sites but with wastes other than POPs (“other” sites); and ZIP codes without any identified hazardous waste sites (“clean” sites). Results Compared with the hospitalization rates for diabetes in clean sites, the rate ratios for diabetes discharges for people residing in POP sites and “other” sites, after adjustment for potential confounders were 1.23 [95% confidence interval (CI), 1.15–1.32] and 1.25 (95% CI, 1.16–1.34), respectively. In a subset of POP sites along the Hudson River, where there is higher income, less smoking, better diet, and more exercise, the rate ratio was 1.36 (95% CI, 1.26–1.47) compared to clean sites. Conclusions After controlling for major confounders, we found a statistically significant increase in the rate of hospitalization for diabetes among the population residing in the ZIP codes containing toxic waste sites. PMID:17366823

  15. EBP partners: doctoral students and practicing clinicians bridging the theory-practice gap.

    PubMed

    Peck, Sydney; Lester, Jennifer; Hinshaw, Ginger; Stiles, Anne; Dingman, Sharon K

    2009-01-01

    The theory-practice gap is one component of the barriers to implementing evidence-based practice. Texas Woman's University College of Nursing and Presbyterian Hospital of Denton joined forces to bridge this gap, allowing doctoral students to provide educational offerings to practicing nurses. Through a Graduate Assistance in Areas of National Need grant, doctoral students completed supervised teaching practicums at the hospital, assisting the hospital to implement evidence-based practice with the ultimate goal of applying for Magnet status. The hospital benefited from the addition of research expertise and mentoring for the staff members. The students benefited from the opportunities to teach and to share knowledge with these clinical experts. This program has been successful in meeting the needs of both parties. Recommendations are given for other institutions interested in establishing similar relationships.

  16. Epidemiology of Medial Ulnar Collateral Ligament Reconstruction: A 10-Year Study in New York State.

    PubMed

    Hodgins, Justin L; Vitale, Mark; Arons, Raymond R; Ahmad, Christopher S

    2016-03-01

    Despite an increase in the prevalence of medial ulnar collateral ligament (UCL) reconstruction of the elbow in professional baseball and popularity within the media, there are no population-based studies examining the incidence of UCL reconstruction. To examine the epidemiological trends of UCL reconstruction on a statewide level over a 10-year period. The primary endpoint was the yearly rate of UCL reconstruction over time; secondary endpoints included patient demographics, institution volumes, and concomitant procedures on the ulnar nerve. Descriptive epidemiology study. The New York Statewide Planning and Research Cooperative System (SPARCS) database contains records for each ambulatory discharge in New York State. This database was used to identify all UCL reconstructions in New York State from 2002 to 2011 using the outpatient CPT-4 (Current Procedural Terminology, 4th Revision) code. Assessed were patient age, sex, ethnicity, insurance status, and associated procedures, as well as hospital volume. There was a significant yearly increase in the number of UCL reconstructions (P < .001) performed in New York State from 2002 to 2011. The volume of UCL reconstructions increased by 193%, and the rate per 100,000 population tripled from 0.15 to 0.45. The mean ± SD age was 21.6 ± 8.89 years, and there was a significant trend for an increased frequency in UCL reconstruction in patients aged 17 to 18 and 19 to 20 years (P < .001). Male patients were 11.8 times more likely to have a UCL reconstruction than female patients (P < .001), and individuals with private insurance were 25 times more likely to have a UCL reconstruction than those with Medicaid (P = .0014). There was a 400% increase in concomitant ulnar nerve release/transposition performed over time in the study period, representing a significant increase in the frequency of ulnar nerve procedures at the time of UCL reconstruction (P < .001). The frequency of UCL reconstruction is steadily rising in New York

  17. 76 FR 40234 - Drawbridge Operation Regulations; Harlem River, New York City, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ...-AA09 Drawbridge Operation Regulations; Harlem River, New York City, NY AGENCY: Coast Guard, DHS. ACTION... at mile 0.0, across the Harlem River at New York City, New York. This interim rule is necessary to... The 103rd Street (Wards Island) Pedestrian Bridge, across the Harlem River, mile 0.0, at New York City...

  18. Police deaths in New York and London during the twentieth century

    PubMed Central

    Kyriacou, D N; Monkkonen, E H; Peek‐Asa, C; Lucke, R E; Labbett, S; Pearlman, K S; Hutson, H R

    2006-01-01

    Objectives To describe the incidences and causes of occupational police deaths in New York City in the United States and Greater London in the United Kingdom during the twentieth century. To assess the relation between overall societal violence and violence directed toward police officers in these metropolitan areas. Design and setting Ecological study of New York and London from 1900 through 1999. Main outcome measures Intentional and unintentional occupational police mortality rates for New York and London were estimated for each decade. The general population homicide rates of both New York and London were assessed for their correlation with their respective intentional occupational police mortality rates. Results During the 20th century, 585 police officers in New York and 160 police officers in London died while participating in law enforcement activities. New York had markedly greater intentional police mortality rates compared to London throughout most of the 20th century, but these differences decreased significantly by the end of the century. Intentional gunshot wounds comprised 290 police deaths in New York, but only 14 police deaths in London. In New York, gun shot wounds (both intentional and unintentional) accounted for more occupational police deaths (51.6%) than did all other injury mechanisms combined. In London, motor vehicle collision was the most common cause (47.5%) of occupational police death. There were no apparent correlations between the general population homicide rates and intentional police mortality rates in either New York (r2 = 0.05, 95% CI −0.77 to 0.81) or London (r2 = 0.34, 95% CI −0.61 to 0.89). Conclusions During the 20th century, both intentional and unintentional occupational police mortality rates were significantly greater in New York compared to London. These differences are likely from several socioeconomic, cultural, and occupational factors. The declines in police deaths in New York during the latter part of

  19. 76 FR 61775 - New York Disaster #NY-00113

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12858 and 12859] New York Disaster NY-00113 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a Notice of the Presidential declaration of a major disaster for Public Assistance Only for the State of New York (FEMA- 4031-DR), dated 09...

  20. 78 FR 26100 - New York Disaster #NY-00134

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-03

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13551 and 13552] New York Disaster NY-00134 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a Notice of the Presidential declaration of a major disaster for Public Assistance Only for the State of New York FEMA-- 4111--DR), dated...

  1. 76 FR 35937 - New York Disaster #NY-00105

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ... U.S. SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12634 and 12635] New York Disaster NY-00105 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a Notice of the Presidential declaration of a major disaster for Public Assistance Only for the State of New York (FEMA- 1993...

  2. 75 FR 21371 - New York Disaster # NY-00089

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-23

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12123 and 12124] New York Disaster NY-00089 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a Notice of the Presidential declaration of a major disaster for Public Assistance Only for the State of New York (FEMA- 1899-DR), dated 04...

  3. 78 FR 44187 - New York Disaster # NY-00136

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-23

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13667 and 13668] New York Disaster NY-00136 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a Notice of the Presidential declaration of a major disaster for Public Assistance Only for the State of New York (FEMA- 4129-DR), dated 07...

  4. Hospitals: Soft Target for Terrorism?

    PubMed

    De Cauwer, Harald; Somville, Francis; Sabbe, Marc; Mortelmans, Luc J

    2017-02-01

    In recent years, the world has been rocked repeatedly by terrorist attacks. Arguably, the most remarkable were: the series of four coordinated suicide plane attacks on September 11, 2001 on buildings in New York, Virginia, and Pennsylvania, USA; and the recent series of two coordinated attacks in Brussels (Belgium), on March 22, 2016, involving two bombings at the departure hall of Brussels International Airport and a bombing at Maalbeek Metro Station located near the European Commission headquarters in the center of Brussels. This statement paper deals with different aspects of hospital policy and disaster response planning that interface with terrorism. Research shows that the availability of necessary equipment and facilities (eg, personal protective clothing, decontamination rooms, antidotes, and anti-viral drugs) in hospitals clearly is insufficient. Emergency teams are insufficiently prepared: adequate and repetitive training remain necessary. Unfortunately, there are many examples of health care workers and physicians or hospitals being targeted in both political or religious conflicts and wars. Many health workers were kidnapped and/or killed by insurgents of various ideology. Attacks on hospitals also could cause long-term effects: hospital units could be unavailable for a long time and replacing staff could take several months, further compounding hospital operations. Both physical and psychological (eg, posttraumatic stress disorder [PTSD]) after-effects of a terrorist attack can be detrimental to health care services. On the other hand, physicians and other hospital employees have shown to be involved in terrorism. As data show that some offenders had a previous history with the location of the terror incident, the possibility of hospitals or other health care services being targeted by insiders is discussed. The purpose of this report was to consider how past terrorist incidents can inform current hospital preparedness and disaster response planning

  5. A Hospital-Specific Template for Benchmarking its Cost and Quality

    PubMed Central

    Silber, Jeffrey H; Rosenbaum, Paul R; Ross, Richard N; Ludwig, Justin M; Wang, Wei; Niknam, Bijan A; Saynisch, Philip A; Even-Shoshan, Orit; Kelz, Rachel R; Fleisher, Lee A

    2014-01-01

    Objective Develop an improved method for auditing hospital cost and quality tailored to a specific hospital’s patient population. Data Sources/Setting Medicare claims in general, gynecologic and urologic surgery, and orthopedics from Illinois, New York, and Texas between 2004 and 2006. Study Design A template of 300 representative patients from a single index hospital was constructed and used to match 300 patients at 43 hospitals that had a minimum of 500 patients over a 3-year study period. Data Collection/Extraction Methods From each of 43 hospitals we chose 300 patients most resembling the template using multivariate matching. Principal Findings We found close matches on procedures and patient characteristics, far more balanced than would be expected in a randomized trial. There were little to no differences between the index hospital’s template and the 43 hospitals on most patient characteristics yet large and significant differences in mortality, failure-to-rescue, and cost. Conclusion Matching can produce fair, directly standardized audits. From the perspective of the index hospital, “hospital-specific” template matching provides the fairness of direct standardization with the specific institutional relevance of indirect standardization. Using this approach, hospitals will be better able to examine their performance, and better determine why they are achieving the results they observe. PMID:25201167

  6. Cosmological history in York time: inflation and perturbations

    NASA Astrophysics Data System (ADS)

    Roser, Philipp; Valentini, Antony

    2017-02-01

    The constant mean extrinsic curvature on a spacelike slice may constitute a physically preferred time coordinate, `York time'. One line of enquiry to probe this idea is to understand processes in our cosmological history in terms of York time. Following a review of the theoretical motivations, we focus on slow-roll inflation and the freezing and Hubble re-entry of cosmological perturbations. While the physics is, of course, observationally equivalent, we show how the mathematical account of these processes is distinct from the conventional account in terms of standard cosmological or conformal time. We also consider the cosmological York-timeline more broadly and contrast it with the conventional cosmological timeline.

  7. Interlibrary Loan in New York State. Recommended Redesign. Results of a Study: Redesign of Interlibrary Loan in New York State.

    ERIC Educational Resources Information Center

    Shoffner, Ralph M.; And Others

    The scope of this study, which was designed to provide information for use in redesigning the interlibrary loan (ILL) system in New York State, was to provide an overview of the ILL structure and patterns in the state; collect and analyze statistical data on ILL in the state and evaluate the performance of the NYSILL (New York State Interlibrary…

  8. Astronomy in New York State: Competence and Challenge.

    ERIC Educational Resources Information Center

    Wood, H. John

    Reported is a survey of astronomy programs in the educational and research institutions in New York State. This report shows that astronomy in New York State is highly diversified; both public and private supported institutions have strong, excellent programs. Many institutions with strong physics departments see the value of growing interaction…

  9. Managing Information in New York State: A Directory.

    ERIC Educational Resources Information Center

    New York State Forum for Information Resource Management.

    This directory compiles state and local information about New York State IT (Information Technology) organizations, their leadership, and staff, in order to facilitate communications that can leverage the experiences of others and better enable pursuance of collaborative efforts to improve the return on the public's investment in New York's…

  10. 76 FR 56856 - New York Disaster Number NY-00108

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12776 and 12777] New York Disaster Number NY... the Presidential declaration of a major disaster for the State of New York (FEMA-4020-DR), dated 08/31... declaration [[Page 56857

  11. Do outcomes after kidney transplantation differ for black patients in England versus New York State? A comparative, population-cohort analysis.

    PubMed

    Tahir, Sanna; Gillott, Holly; Jackson-Spence, Francesca; Nath, Jay; Mytton, Jemma; Evison, Felicity; Sharif, Adnan

    2017-05-09

    Inferior outcomes for black kidney transplant recipients in the USA may not be generalisable elsewhere. In this population cohort analysis, we compared outcomes for black kidney transplant patients in England versus New York State. Retrospective, comparative, population cohort study utilising administrative data registries. English data were derived from Hospital Episode Statistics, while New York State data were derived from Statewide Planning and Research Cooperative System. All adults receiving their first kidney-alone allograft between 2003 and 2013 were eligible for inclusion. The primary outcome measure was mortality post kidney transplantation (including inhospital death, 30-day mortality and 1-year mortality). Secondary outcome measures included postoperative admission length of stay, risk of rehospitalisation, development of cardiac events, stroke, cancer or fracture and finally transplant rejection/failure. Cox proportional hazards regression was used to investigate relationship between ethnicity, country and outcome. Black patients comprised 6.5% of the English cohort (n=1215/18 493) and 23.0% of the New York State cohort (n=2660/11 602). Compared with New York State, black kidney transplant recipients in England were more likely younger, male, living-donor kidney recipients and had dissimilar medical comorbidities. Inpatient mortality was not statistically different, but death within 30 days, 1 year or kidney transplant rejection/failure was lower among black patients in England versus black patients in New York State. In adjusted regression analysis, with black ethnicity the reference group, white patients had reduced risk for 30-day mortality (OR 0.62 (95% CI 0.44 to 0.86)) and 1-year mortality (OR 0.79 (95% CI 0.63 to 0.99)) in New York State but no difference was observed in England. Compared with England, black kidney transplant patients in New York State had increased HR for kidney transplant rejection rejection/failure by median follow-up (HR

  12. Health Impact in New York City During the Northeastern Blackout of 2003

    PubMed Central

    Lin, Shao; Fletcher, Barbara A.; Luo, Ming; Chinery, Robert; Hwang, Syni-An

    2011-01-01

    Objective This study assessed the health effects of the 2003 Northeastern blackout, the largest one in history, on mortality and hospital admissions due to respiratory, cardiovascular, and renal diseases in New York City (NYC), and compared the disease patterns and sociodemographic profiles of cases during the blackout with those on control days. Method We investigated the effects of the blackout on health using incidence rate ratios to compare the disease on blackout days (August 14 and 15, 2003) with those on normal and comparably hot days (controls). Normal days were defined as summer days (June–August) between the 25th and 75th percentiles of maximum temperature during 1991–2004. Comparably hot days were days with maximum temperatures in the same range as that of the blackout days. We evaluated the interactive effects of demographics and the blackout using a case-only design. Results We found that mortality and respiratory hospital admissions in NYC increased significantly (two- to eightfold) during the blackout, but cardiovascular and renal hospitalizations did not. The most striking increases occurred among elderly, female, and chronic bronchitis admissions. We identified stronger effects during the blackout than on comparably hot days. In contrast to the pattern observed for comparably hot days, higher socioeconomic status groups were more likely to be hospitalized during the blackout. Conclusions This study suggests that power outages may have important health impacts, even stronger than the effects of heat alone. The findings provide some direction for future emergency planning and public health preparedness. PMID:21553667

  13. 40 CFR 272.1651 - New York State-Administered Program: final authorization.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false New York State-Administered Program... (CONTINUED) SOLID WASTES (CONTINUED) APPROVED STATE HAZARDOUS WASTE MANAGEMENT PROGRAMS New York § 272.1651 New York State-Administered Program: final authorization. (a) Pursuant to section 3006(b) of RCRA, 42...

  14. 78 FR 51061 - Special Anchorage Areas; Port of New York, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-20

    ...-AA01 Special Anchorage Areas; Port of New York, NY AGENCY: Coast Guard, DHS. ACTION: Final rule...; revising the New York City Harbor Master phone number for Sheepshead Bay, NY; and disestablishing the Captain of the Port New York Commercial Mooring Buoy permit regulations and table displaying the mooring...

  15. [Caesarean section in german hospitals: validity of hospital quality report data for monitoring C-section rates].

    PubMed

    Junghänel, K; Renz-Polster, H; Jarczok, M N; Hornemann, A; Böhler, T; De Bock, F

    2015-04-01

    It is not known if "hospital quality reports" (HQR) document Caesarean (C-) section rates at the hospital level accurately enough for use as a reliable data source when it comes to explaining regional variations of C-sections in Germany by factors at the hospital level. We aimed to answer this question using HQR from hospitals in Baden-Württemberg as data source. Diagnostic and procedure codes from HQR for the year 2008 (HQRdata), were used to calculate numbers of births, numbers of C-sections, and rates of births by C-section (CSR) for 94 of 97 hospitals in Baden-Württemberg. These numbers were compared to internal hospital (IH) data delivered upon request by 80 of 97 hospitals and stemming from vital statistics, birth registry forms, or external quality assurance datasets. There was no difference in the number of births between HQR data and IH data, but the number of C-sections and the CSR differed significantly (p<0.05; Wilcoxon rank sum test). CSR calculated using HQR data was 4.9 ± 17.9% higher than CSR from IH data (absolute difference 1.5 ± 5.8%). The correlation between the 2 data sources was moderate (r=0.73). Only 55% of the variance in IH data-based CSR was explained by HQR data. The proportion between highest and lowest CSR in hospitals in Baden-Württemberg was 4.9 for HQR data and 3.6 for IH data. There are significant and relevant differences between C-section rates based on ei-ther HQR or IH data. This questions routine data from HQR for 2008 as a reliable data source for research work. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Assisting New York Dairy Farms with Preparing for OSHA Safety Inspections.

    PubMed

    Tinc, Pamela J; Carrabba, Jim; Meyerhoff, Anna; Horsman, Melissa

    2018-01-01

    In 2013, the Occupational Safety and Health Administration announced a Local Emphasis Program targeted at New York farmers. This program involved random inspections of dairy farms across the state. This article provides an overview of the efforts made in New York to prepare farmers for these inspections. As a result of this program launch, several safety services offered by the New York Center for Agricultural Medicine and Health were significantly impacted, and required expansion and modification in order to meet the needs of New York farmers.

  17. Free Trade for New York: The Economic Impact of the Canada-United States Free Trade Agreement on New York State. Rockefeller Institute Special Report Number 30.

    ERIC Educational Resources Information Center

    Doh, Jonathan P.

    This paper assesses the potential impact on the New York State economy, industries, and regions of the recently implemented Canada-U.S. Free Trade Agreement (FTA). Canadian trade and investment have had significant impacts on the economies of the United States and New York state. An analysis of the potential impact of the FTA on New York state,…

  18. 46 CFR 7.30 - New York Harbor, NY.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false New York Harbor, NY. 7.30 Section 7.30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC BOUNDARY LINES Atlantic Coast § 7.30 New York Harbor, NY. A line drawn from East Rockaway Inlet Breakwater Light to Ambrose Light...

  19. Student Achievement in New York State, 1985-86.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Div. of Educational Testing.

    This report summarizes the 1985-86 results for three New York state examination programs--the elementary school Pupil Evaluation Program (PEP) and the high school Regents and Regents Competency Tests. Results on the PEP showed passing rates improved steadily over the last four years. About one-half of New York State's graduating seniors are…

  20. Charter School Funding: Inequity in New York City

    ERIC Educational Resources Information Center

    Maloney, Larry D.; Wolf, Patrick J.

    2017-01-01

    New York City was home to 1,575 district and 183 charter schools in Fiscal Year 2014 (FY2014). Seven percent of all public school students in New York City attended charter schools that year. Researchers systematically reviewed funding and spending documents involving the city's district-run and independent charter schools for FY2014. Research…

  1. Readmissions After Colectomy: The Upstate New York Surgical Quality Initiative Experience.

    PubMed

    Hensley, Bradley J; Cooney, Robert N; Hellenthal, Nicholas J; Aquina, Christopher T; Noyes, Katia; Monson, John R; Kelly, Kristin N; Fleming, Fergal J

    2016-05-01

    Hospital readmissions remain a major medical and financial concern to the healthcare system and have become an area of interest in health outcomes performance metrics. There is a pressing need to identify process measures that may help reduce readmissions. Our aim was to assess the patient characteristics and surgical factors associated with 30-day readmissions for colorectal surgery in Upstate New York. This was a retrospective cohort study. The study included colectomy cases abstracted for the National Surgical Quality Improvement Program in the Upstate New York Surgical Quality Initiative from June 2013 to June 2014. The study consists of 630 colectomies. Patients with a length of stay >30 days or who died during the index admission were excluded. Readmission within 30 days of surgery was the main outcome measure. Of 630 colectomy patients, 76 patients (12%) were readmitted within 30 days of surgery. Major and minor complications were associated with 30-day postoperative readmission (OR = 2.99 (95% CI, 1.70-5.28) and OR = 2.19 (95% CI, 1.09-4.43)) but excluded from final analysis because they included both predischarge and postdischarge complications. Risk factors independently associated with 30-day postoperative readmission included diabetes mellitus (OR = 1.94 (95% CI, 1.02-3.67)), smoker within the past year (OR = 2.01 (95% CI, 1.12-3.60)), no scheduled follow-up (OR = 2.20 (95% CI, 1.25-3.86)), and ileostomy formation (OR = 1.97 (95% CI, 1.03-3.77)). Limitations include the retrospective design and only 30 days of postoperative follow-up. Consistent with national trends, 1 in 8 patients in the Upstate New York Surgical Quality Initiative program was readmitted within 30 days after colorectal surgery. This study identified several risk factors that may act as tangible targets for intervention, including preoperative smoking cessation programs, optimization of diabetic management, mandatory scheduled follow-up appointments on discharge, and ostomy care

  2. Redesigning the Regulatory Framework for Ambulatory Care Services in New York

    PubMed Central

    Chokshi, Dave A; Rugge, John; Shah, Nirav R

    2014-01-01

    Context While hospitals remain important centers of gravity in the health system, services are increasingly being delivered through ambulatory care. This shift to ambulatory care is giving rise to new delivery structures, such as retail clinics and urgent care centers, as well as reinventing existing ambulatory care capacity, as seen with the patient-centered medical home model and the movement toward team-based care. To protect the public's interests, oversight of ambulatory care services must keep pace with these rapid changes. With this purpose, in January 2013 the New York Public Health and Health Planning Council undertook a redesign of the regulatory framework for the state's ambulatory care services. This article describes the principles undergirding the framework as well as the regulatory recommendations themselves. Methods We explored and analyzed the regulation of ambulatory care services in New York in accordance with the available gray and peer-reviewed literature and legislative documents. The deliberations of the Public Health and Health Planning Council informed our review. Findings The vision of high-performing ambulatory care should be rooted in the Triple Aim (better health, higher-quality care, lower costs), with a particular emphasis on continuity of care for patients. There is a pressing need to better define the taxonomy of ambulatory care services. From the state government's perspective, this clarification requires better reporting from new health care entities (eg, retail clinics), connections with regional and state health information technology hubs, and coordination among state agencies. A uniform nomenclature also would improve consumers’ understanding of rights and responsibilities. Finally, the regulatory mechanisms employed—from mandatory reporting to licensure to regional planning to the certificate of need—should remain flexible and match the degree of consensus regarding the appropriate regulatory path. Conclusions Few other

  3. The York Gospels: a 1000-year biological palimpsest

    PubMed Central

    Fiddyment, Sarah; Vnouček, Jiří; Mattiangeli, Valeria; Speller, Camilla; Binois, Annelise; Carver, Martin; Dand, Catherine; Newfield, Timothy P.; Webb, Christopher C.; Bradley, Daniel G.; Collins, Matthew J.

    2017-01-01

    Medieval manuscripts, carefully curated and conserved, represent not only an irreplaceable documentary record but also a remarkable reservoir of biological information. Palaeographic and codicological investigation can often locate and date these documents with remarkable precision. The York Gospels (York Minster Ms. Add. 1) is one such codex, one of only a small collection of pre-conquest Gospel books to have survived the Reformation. By extending the non-invasive triboelectric (eraser-based) sampling technique eZooMS, to include the analysis of DNA, we report a cost-effective and simple-to-use biomolecular sampling technique for parchment. We apply this combined methodology to document for the first time a rich palimpsest of biological information contained within the York Gospels, which has accumulated over the 1000-year lifespan of this cherished object that remains an active participant in the life of York Minster. These biological data provide insights into the decisions made in the selection of materials, the construction of the codex and the use history of the object. PMID:29134095

  4. New York State oil company gross receipts taxation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brown, P.E., Jr.

    1983-12-01

    New York's Governor Cuomo was able to mediate a settlement with 18 major oil companies subject to gross receipts taxation. The compromise was intended to end three years of litigation and to assure a tax revenue flow to the state of hundreds of millions of dollars. It represents New York's effort to single out a handful of large national companies for special burdens and a final resolution of a dispute over the state's attempt to prevent these companies from passing through their tax liabilities to consumers in the prices of petroleum products. This article reviews oil company taxation in Newmore » York State and the effects of the recent accord. 95 references.« less

  5. The Regionalization of Total Ankle Arthroplasties and Ankle Fusions in New York State: A 10-Year Comparative Analysis.

    PubMed

    Buza, John A; Liu, James X; Jancuska, Jeffrey; Bosco, Joseph A

    2017-06-01

    Total ankle arthroplasty (TAA) provides an alternative to ankle fusion (AF). The purpose of this study is to (1) determine the extent of TAA regionalization, as well as examine the growth of TAA performed at high-, medium-, and low-volume New York State institutions and (2) compare this regionalization and growth with AF. The New York Statewide Planning and Research Cooperative System (SPARCS) administrative data were used to identify 737 primary TAA and 7453 AF from 2005 to 2014. The volume of TAA and AF surgery in New York State was mapped according to patient and hospital 3-digit zip code. The number of TAA per year grew 1500% (from 11 to 177) from 2005 to 2014, while there was a 35.6% reduction (from 895 to 576) in yearly AF procedures. TAA recipients were widely distributed throughout the state, while TAA procedures were regionalized to a few select metropolitan centers. AF procedures were performed more uniformly than TAA. The number of TAA has continued to increase at high- (15 to 91) and medium-volume (14 to 67) institutions where it has decreased at low-volume institutions (44 to 19). The increased utilization of TAA is attributed to relatively few high-volume centers located in major metropolitan centers. Level IV: well-designed case-control or cohort studies.

  6. The Professional Educator: Notes from New York City

    ERIC Educational Resources Information Center

    Mulgrew, Michael

    2014-01-01

    In New York City, as in many places across the country, there is much discussion about strengthening career and technical education (CTE). New York City's approach to Career and Technical Education (CTE) is held up as a model for getting this type of education right. A recent conference highlighted six schools that represented only a fraction of…

  7. Education Reform in New York City (2002-2013)

    ERIC Educational Resources Information Center

    Elwick, Alex

    2017-01-01

    In 2002 Michael Bloomberg took office as Mayor of New York City and, over the next 12 years of his administration, oversaw a series of sweeping reforms in order to "fix" the broken education system which he believed he had inherited. This paper details the key policy reforms in New York City's public school system during this period,…

  8. Dissolved methane in New York groundwater, 1999-2011

    USGS Publications Warehouse

    Kappel, William M.; Nystrom, Elizabeth A.

    2012-01-01

    New York State is underlain by numerous bedrock formations of Cambrian to Devonian age that produce natural gas and to a lesser extent oil. The first commercial gas well in the United States was dug in the early 1820s in Fredonia, south of Buffalo, New York, and produced methane from Devonian-age black shale. Methane naturally discharges to the land surface at some locations in New York. At Chestnut Ridge County Park in Erie County, just south of Buffalo, N.Y., several surface seeps of natural gas occur from Devonian black shale, including one behind a waterfall. Methane occurs locally in the groundwater of New York; as a result, it may be present in drinking-water wells, in the water produced from those wells, and in the associated water-supply systems (Eltschlager and others, 2001). The natural gas in low-permeability bedrock formations has not been accessible by traditional extraction techniques, which have been used to tap more permeable sandstone and carbonate bedrock reservoirs. However, newly developed techniques involving horizontal drilling and high-volume hydraulic fracturing have made it possible to extract previously inaccessible natural gas from low-permeability bedrock such as the Marcellus and Utica Shales. The use of hydraulic fracturing to release natural gas from these shale formations has raised concerns with water-well owners and water-resource managers across the Marcellus and Utica Shale region (West Virginia, Pennsylvania, New York and parts of several other adjoining States). Molofsky and others (2011) documented the widespread natural occurrence of methane in drinking-water wells in Susquehanna County, Pennsylvania. In the same county, Osborn and others (2011) identified elevated methane concentrations in selected drinking-water wells in the vicinity of Marcellus gas-development activities, although pre-development samples were not available for comparison. In order to manage water resources in areas of gas-well drilling and hydraulic

  9. 8. Historic American Buildings Survey PHOTOCOPY ORIGINAL ARCHITECTS' DRAWING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. Historic American Buildings Survey PHOTOCOPY -- ORIGINAL ARCHITECTS' DRAWING IN INK ON LINEN (ABOUT 3'-7'x2'-7 1/2') (C. 1889). ORIGINAL IN THE COLLECTION OF THE PRESBYTERIAN CHURCH, ST. AUGUSTINE, FLORIDA - Flagler Memorial Presbyterian Church, Valencia & Sevilla Streets, Saint Augustine, St. Johns County, FL

  10. First-Year Analysis of a New, Home-Based Palliative Care Program Offered Jointly by a Community Hospital and Local Visiting Nurse Service.

    PubMed

    Pouliot, Katherine; Weisse, Carol S; Pratt, David S; DiSorbo, Philip

    2017-03-01

    There is a growing need for home-based palliative care services, especially for seriously ill individuals who want to avoid hospitalizations and remain with their regular outside care providers. To evaluate the effectiveness of Care Choices, a new in-home palliative care program provided by the Visiting Nurse Services of Northeastern New York and Ellis Medicine's community hospital serving New York's Capital District. This prospective cohort study assessed patient outcomes over the course of 1 year for 123 patients (49 men and 74 women) with serious illnesses who were new enrollees in the program. Quality of life was assessed at baseline and after 1 month on service. Satisfaction with care was measured after 1 and 3 months on service. The number of emergency department visits and inpatient hospitalizations pre- and postenrollment was measured for all enrollees. Patients were highly satisfied (72.7%-100%) with their initial care and reported greater satisfaction ( P < .05) and stable symptom management over time. Fewer emergency department ( P < .001) and inpatient hospital admissions ( P < .001) occurred among enrollees while on the palliative care service. An in-home palliative care program offered jointly through a visiting nurse service and community hospital may be a successful model for providing quality care that satisfies chronically ill patients' desire to remain at home and avoid hospital admissions.

  11. Tracking the demise of state hospital rate setting.

    PubMed

    McDonough, J E

    1997-01-01

    From its once preeminent position in state health policy, prospective hospital rate setting has declined in use from more than thirty states in 1980 to two today. This essay tracks the trend toward deregulation in various states--especially Massachusetts, New Jersey, and New York-- and examines the continuation of rate setting in Maryland. Principally, the decline reflects the development of managed care and capitation as alternative means to control health spending growth. This trend represents both an evolution in prospective payment methodology and a renewed preference for private over public-sector price controls.

  12. Health Care Marketing at Keller Army Community Hospital West Point, New York

    DTIC Science & Technology

    1982-08-01

    Kotler , Philip . Marketing for Nonprofit Organizations. Englewood Cliffs: Prentice-Hall, Inc., 1975. MacStravic, Robin E. Marketing Health Care. Germantown...102 (17 November 1980): 68-81. Kotler , Philip . "What Consumerism Means for Marketers." Harvard Business Review. (May-June, 1972): 50-56. and Levy...As a corollary, Kotler predicts that "between 1,000 and 1,500 hospitals of the 7,000 in the U.S. will close in the next five years.. .one reason

  13. 76 FR 58557 - New York Disaster Number NY-00109

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12778 and 12779] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the President's major disaster declaration for Private Non-Profit organizations in the State of New...

  14. 76 FR 58558 - New York Disaster Number NY-00109

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12778 and 12779] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the President's major disaster declaration for Private Non-Profit organizations in the State of New...

  15. 77 FR 70203 - New York Disaster Number NY-00131

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13374 and 13375] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the President's major disaster declaration for Private Non-Profit organizations in the State of NEW...

  16. 77 FR 71666 - New York Disaster Number NY-00131

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-03

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13374 and 13375] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the President's major disaster declaration for Private Non-Profit organizations in the State of New...

  17. 76 FR 58559 - New York Disaster Number NY-00109

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12778 and 12779] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the President's major disaster declaration for Private Non-Profit organizations in the State of New...

  18. 76 FR 56855 - New York Disaster Number NY-00109

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12778 and 12779] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the President's major disaster declaration for Private Non-Profit organizations in the State of New...

  19. 77 FR 76587 - New York Disaster Number NY-00131

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-28

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13374 and 13375] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the President's major disaster declaration for Private Non-Profit organizations in the State of New...

  20. 76 FR 59178 - New York Disaster Number NY-00109

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-23

    ... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12778 and 12779] New York Disaster Number NY... the Presidential declaration of a major disaster for Public Assistance Only for the State of New York... the President's major disaster declaration for Private Non-Profit organizations in the State of New...

  1. Vibration level data Brighton-New York City Transit Authority

    DOT National Transportation Integrated Search

    1980-08-31

    This report documents the results of a vibration measurement program conducted on 14-15 August 1980 in the Midwood Section of Brooklyn, New York, next to the tracks of the Brighton Line of the New York City Transit Authority. The test was conducted b...

  2. Is there a link between the hospital-acquired injurious fall rates in US acute care hospitals and these institutions' implementation levels of computerized systems?

    PubMed

    Tzeng, Huey-Ming; Hu, Hsou Mei; Yin, Chang-Yi

    2011-12-01

    Medicare no longer reimburses acute care hospitals for the costs of additional care required due to hospital-acquired injuries. Consequently, this study explored the effective computerized systems to inform practice for better interventions to reduce fall risk. It provided a correlation between type of computerized system and hospital-acquired injurious fall rates at acute care hospitals in California, Florida, and New York. It used multiple publicly available data sets, with the hospital as the unit of analysis. Descriptive and Pearson correlation analyses were used. The analysis included 462 hospitals. Significant correlations could be categorized into two groups: (1) meaningful computerized systems that were associated with lower injurious fall rates: the decision support systems for drug allergy alerts, drug-drug interaction alerts, and drug-laboratory interaction alerts; and (2) computerized systems that were associated with higher injurious fall rates: the decision support system for drug-drug interaction alerts and the computerized provider order entry system for radiology tests. Future research may include additional states, multiple years of data, and patient-level data to validate this study's findings. This effort may further inform policy makers and the public about effective clinical computerized systems provided to clinicians to improve their practice decisions and care outcomes.

  3. Molecular epidemiology of eastern equine encephalitis Virus, New York

    USGS Publications Warehouse

    Young, David S.; Kramer, Laura D.; Maffei, Joseph G.; Dusek, Robert J.; Backenson, P. Bryon; Mores, Christopher N.; Bernard, Kristen A.; Ebel, Gregory D.

    2008-01-01

    Perpetuation, overwintering, and extinction of eastern equine encephalitis virus (EEEV) in northern foci are poorly understood. We therefore sought to describe the molecular epidemiology of EEEV in New York State during current and past epizootics. To determine whether EEEV overwinters, is periodically reintroduced, or both, we sequenced the E2 and partial NSP3 coding regions of 42 EEEV isolates from New York State and the Eastern Seaboard of the United States. Our phylogenetic analyses indicated that derived subclades tended to contain southern strains that had been isolated before genetically similar northern strains, suggesting southern to northern migration of EEEV along the Eastern Seaboard. Strong clustering among strains isolated during epizootics in New York from 2003–2005, as well as from 1974–1975, demonstrates that EEEV has overwintered in this focus. This study provides molecular evidence for the introduction of southern EEEV strains to New York, followed by local amplification, perpetuation, and overwintering.

  4. Risk Factors for Serogroup C Meningococcal Disease during Outbreak among Men who Have Sex with Men, New York City, New York, USA.

    PubMed

    Ridpath, Alison; Greene, Sharon K; Robinson, Byron F; Weiss, Don

    2015-08-01

    Risk factors for illness during a serogroup C meningococcal disease outbreak among men who have sex with men in New York City, New York, USA, in 2012-2013 included methamphetamine and cocaine use and sexually transmitted infections. Outbreak investigations should consider routinely capturing information regarding drug use and sex-related risk factors.

  5. Disaster Resiliency and Recovery Example Project: New Jersey and New York |

    Science.gov Websites

    Integrated Energy Solutions | NREL Jersey and New York Disaster Resiliency and Recovery Example Project: New Jersey and New York Image of a pile of debris in front of a house with one wall missing . Houses in New York and New Jersey were severely damaged during Hurricane Sandy. On Oct. 29, 2012

  6. A case study of the impact of inaccurate cause-of-death reporting on health disparity tracking: New York City premature cardiovascular mortality.

    PubMed

    Johns, Lauren E; Madsen, Ann M; Maduro, Gil; Zimmerman, Regina; Konty, Kevin; Begier, Elizabeth

    2013-04-01

    Heart disease death overreporting is problematic in New York City (NYC) and other US jurisdictions. We examined whether overreporting affects the premature (< 65 years) heart disease death rate disparity between non-Hispanic Blacks and non-Hispanic Whites in NYC. We identified overreporting hospitals and used counts of premature heart disease deaths at reference hospitals to estimate corrected counts. We then corrected citywide, age-adjusted premature heart disease death rates among Blacks and Whites and a White-Black premature heart disease death disparity. At overreporting hospitals, 51% of the decedents were White compared with 25% at reference hospitals. Correcting the heart disease death counts at overreporting hospitals decreased the age-adjusted premature heart disease death rate 10.1% (from 41.5 to 37.3 per 100,000) among Whites compared with 4.2% (from 66.2 to 63.4 per 100,000) among Blacks. Correction increased the White-Black disparity 6.1% (from 24.6 to 26.1 per 100,000). In 2008, NYC's White-Black premature heart disease death disparity was underestimated because of overreporting by hospitals serving larger proportions of Whites. Efforts to reduce overreporting may increase the observed disparity, potentially obscuring any programmatic or policy-driven advances.

  7. 75 FR 23640 - Approval and Promulgation of Implementation Plans; New York Reasonably Available Control...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ... Promulgation of Implementation Plans; New York Reasonably Available Control Technology and Reasonably Available... 25, 2009, the EPA proposed to disapprove portions of a proposed revision to the New York State.... Specifically, EPA proposed to disapprove New York's reasonably available control measure analysis and New York...

  8. Serving high-risk foods in a high-risk setting: survey of hospital food service practices after an outbreak of listeriosis in a hospital.

    PubMed

    Cokes, Carolyn; France, Anne Marie; Reddy, Vasudha; Hanson, Heather; Lee, Lillian; Kornstein, Laura; Stavinsky, Faina; Balter, Sharon

    2011-04-01

    Prepared ready-to-eat salads and ready-to-eat delicatessen-style meats present a high risk for Listeria contamination. Because no foodborne illness risk management guidelines exist specifically for US hospitals, a survey of New York City (NYC) hospitals was conducted to characterize policies and practices after a listeriosis outbreak occurred in a NYC hospital. From August through October 2008, a listeriosis outbreak in a NYC hospital was investigated. From February through April 2009, NYC's 61 acute-care hospitals were asked to participate in a telephone survey regarding food safety practices and policies, specifically service of high-risk foods to patients at increased risk for listeriosis. Five patients with medical conditions that put them at high risk for listeriosis had laboratory-confirmed Listeria monocytogenes infection. The Listeria outbreak strain was isolated from tuna salad prepared in the hospital. Fifty-four (89%) of 61 hospitals responded to the survey. Overall, 81% of respondents reported serving ready-to-eat deli meats to patients, and 100% reported serving prepared ready-to-eat salads. Pregnant women, patients receiving immunosuppressive drugs, and patients undergoing chemotherapy were served ready-to-eat deli meats at 77%, 59%, and 49% of hospitals, respectively, and were served prepared ready-to-eat salads at 94%, 89%, and 73% of hospitals, respectively. Only 4 (25%) of 16 respondents reported having a policy that ready-to-eat deli meats must be heated until steaming hot before serving. Despite the potential for severe outcomes of Listeria infection among hospitalized patients, the majority of NYC hospitals had no food preparation policies to minimize risk. Hospitals should implement policies to avoid serving high-risk foods to patients at risk for listeriosis.

  9. 40 CFR 81.127 - Central New York Intrastate Air Quality Control Region.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Central New York Intrastate Air... Air Quality Control Regions § 81.127 Central New York Intrastate Air Quality Control Region. The Central New York Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

  10. [Instruments of management accounting in german hospitals - potentials for competitive advantage and status quo].

    PubMed

    Berens, W; Lachmann, M; Wömpener, A

    2011-03-01

    The aim of this study is to provide an analysis of the status quo for the usage of instruments of management accounting in German hospitals. 600 managing directors of German hospitals were asked to answer a questionnaire about the usage of management accounting instruments in their hospitals. We obtained 121 usable datasets, which are evaluated in this study. A significant increase in the usage of management accounting instruments can be observed over time. The respondents have an overall positive perception of the usage of these instruments. Cost accounting and information systems are among the most widely used instruments, while widely discussed concepts like the balanced scorecard or clinical pathways show surprisingly low usage rates. © Georg Thieme Verlag KG Stuttgart · New York.

  11. A GIS Based Approach for Assessing the Association between Air Pollution and Asthma in New York State, USA

    PubMed Central

    Gorai, Amit K.; Tuluri, Francis; Tchounwou, Paul B.

    2014-01-01

    Studies on asthma have shown that air pollution can lead to increased asthma prevalence. The aim of this study is to examine the association between air pollution (fine particulate matter (PM2.5), sulfur dioxide (SO2) and ozone (O3)) and human health (asthma emergency department visit rate (AEVR) and asthma discharge rate (ADR)) among residents of New York, USA during the period 2005 to 2007. Annual rates of asthma were calculated from population estimates for 2005, 2006, and 2007 and number of asthma hospital discharge and emergency department visits. Population data for New York were taken from US Bureau of Census, and asthma data were obtained from New York State Department of Health, National Asthma Survey surveillance report. Data on the concentrations of PM2.5, SO2 and ground level ozone were obtained from various air quality monitoring stations distributed in different counties. Annual means of these concentrations were compared to annual variations in asthma prevalence by using Pearson correlation coefficient. We found different associations between the annual mean concentration of PM2.5, SO2 and surface ozone and the annual rates of asthma discharge and asthma emergency visit from 2005 to 2007. A positive correlation coefficient was observed between the annual mean concentration of PM2.5, and SO2 and the annual rates of asthma discharge and asthma emergency department visit from 2005 to 2007. However, the correlation coefficient between annual mean concentrations of ground ozone and the annual rates of asthma discharge and asthma emergency visit was found to be negative from 2005 to 2007. Our study suggests that the association between elevated concentrations of PM2.5 and SO2 and asthma prevalence among residents of New York State in USA is consistent enough to assume concretely a plausible and significant association. PMID:24806193

  12. Correlation of Subjective Hospital Compare Metrics With Objective Outcomes of Cranial Neurosurgical Procedures in New York State.

    PubMed

    Bekelis, Kimon; Missios, Symeon; Coy, Shannon; Rahmani, Redi; MacKenzie, Todd A; Asher, Anthony L

    2017-03-01

    Public reporting is at the forefront of health care reform. To investigate whether patient satisfaction as expressed in a public reporting platform correlates with objective outcomes for cranial neurosurgery patients. We performed a cohort study involving patients undergoing cranial neurosurgery from 2009 to 2013 who were registered in the Statewide Planning and Research Cooperative System database. This cohort was merged with the corresponding data from the Centers for Medicare and Medicaid Services Hospital Compare website. The association of patient satisfaction metrics with outcomes was examined with the use of a propensity-adjusted regression model. Overall, 19 591 patients underwent cranial neurosurgery during the study. Using a propensity-adjusted multivariable regression analysis, we demonstrated that hospitals with a greater percentage of patient-assigned "high" scores had decreased mortality (OR, 0.60; 95% CI, 0.53-0.67), rate of discharge to rehabilitation (OR, 0.93; 95% CI, 0.88-0.98), length of stay (adjusted difference, -1.29; 95% CI, -1.46 to -1.13), and hospitalization charges (adjusted difference, -23%; 95% CI, -36% to -9%) after cranial neurosurgery. Similar associations were identified for hospitals with a higher percentage of patients, who would recommend these institutions to others. In a Centers for Medicare and Medicaid Services Hospital Compare-Statewide Planning and Research Cooperative System merged dataset, we observed an association of higher performance in patient satisfaction measures with decreased mortality, rate of discharge to rehabilitation, hospitalization charges, and length of stay. Copyright © 2017 by the Congress of Neurological Surgeons

  13. Redesigning the regulatory framework for ambulatory care services in New York.

    PubMed

    Chokshi, Dave A; Rugge, John; Shah, Nirav R

    2014-12-01

    Policy Points: The landscape of ambulatory care services in the United States is rapidly changing on account of payment reform, primary care transformation, and the rise of convenient care options such as retail clinics. New York State has undertaken a redesign of regulatory policy for ambulatory care rooted in the Triple Aim (better health, higher-quality care, lower costs)-with a particular emphasis on continuity of care for patients. Key tenets of the regulatory approach include defining and tracking the taxonomy of ambulatory care services as well as ensuring that convenient care options do not erode continuity of care for patients. While hospitals remain important centers of gravity in the health system, services are increasingly being delivered through ambulatory care. This shift to ambulatory care is giving rise to new delivery structures, such as retail clinics and urgent care centers, as well as reinventing existing ambulatory care capacity, as seen with the patient-centered medical home model and the movement toward team-based care. To protect the public's interests, oversight of ambulatory care services must keep pace with these rapid changes. With this purpose, in January 2013 the New York Public Health and Health Planning Council undertook a redesign of the regulatory framework for the state's ambulatory care services. This article describes the principles undergirding the framework as well as the regulatory recommendations themselves. We explored and analyzed the regulation of ambulatory care services in New York in accordance with the available gray and peer-reviewed literature and legislative documents. The deliberations of the Public Health and Health Planning Council informed our review. The vision of high-performing ambulatory care should be rooted in the Triple Aim (better health, higher-quality care, lower costs), with a particular emphasis on continuity of care for patients. There is a pressing need to better define the taxonomy of ambulatory

  14. Trends in the first ten years of AIDS in New York City. The New York City Department of Health AIDS Surveillance Team.

    PubMed

    Thomas, P A; Weisfuse, I B; Greenberg, A E; Bernard, G A; Tytun, A; Stellman, S D

    1993-01-15

    With over 37,000 cases of acquired immunodeficiency syndrome (AIDS) reported by the end of 1991, New York City had reported nearly 20% of all US cases in the first decade of the AIDS epidemic. This report examines cases diagnosed through 1990 and reported through 1991 to describe rates and trends in the affected subpopulations. Case data were collected by the New York City Department of Health AIDS Surveillance Team, using a format standardized by the federal Centers for Disease Control. Deaths attributable to human immunodeficiency virus (HIV) infection were examined using data provided by the New York City Department of Health Bureau of Vital Statistics. From 1981 through 1990, 37,436 cases of AIDS were diagnosed: 83% in men over the age of 19 years, 15% in women over 19, 2% in children under 13, and less than 1% in teenagers aged 13-19. Cumulative rates in New York City adults were as high as 100 per 10,000 in nine neighborhoods. Predominant trends included a sustained plateau in reported incidence in men who reported having sex with men and a continuing rise in cases in injection drug users and women infected through heterosexual intercourse. HIV-related deaths in men, women, and children were continuing to rise at the end of the decade. During the first decade of the AIDS/HIV epidemic, case surveillance in New York City measured the visible portion of the epidemic and provided important data on subepidemics.

  15. Dialect Boundaries and Phonological Change in Upstate New York

    ERIC Educational Resources Information Center

    Dinkin, Aaron Joshua

    2009-01-01

    The eastern half of New York State is a dialectologically diverse region around which several dialect regions converge--the Inland North, New York City, Western New England, and Canada. These regions differ with respect to major parameters of North American English phonological variation; and therefore the interface between them is of interest…

  16. Rural Transportation in New York State: A Preliminary Report.

    ERIC Educational Resources Information Center

    New York State Legislative Commission on Rural Resources, Albany.

    The report catalogs strengths, defines problems, and establishes goals for the next two decades for rural New York in the area of transportation. Describing where rural New York is today, section one lists 12 trends, 8 strengths, and 16 weaknesses affecting transporation. Trends include increased rural population inflow and demands on local…

  17. Trends in Birth Rates: New York City 1970-1995.

    ERIC Educational Resources Information Center

    Finkel, Madelon L.; Elkin, Elena

    2001-01-01

    Examined teen birth rates in New York City health districts over 25 years, noting ethnic variations. Data from Department of Health vital statistics indicated that the decline in the birth rate among New York City teens was most significant in health districts populated predominantly by blacks. There were substantial decreases among older teens…

  18. Making Safety Systematic at City University of New York.

    ERIC Educational Resources Information Center

    Dodson, Ann Elizabeth; Hundley, Esther

    2002-01-01

    Describes a program involving the Dormitory Authority of the State of New York (DASNY) and the City University of New York (CUNY) in which a private contractor provides annual loss-prevention surveys and detailed safety reports for buildings at every CUNY campus. Discusses why the program has worked and its benefits. (EV)

  19. 33 CFR 110.166 - York River, Va., naval anchorage.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... ANCHORAGES ANCHORAGE REGULATIONS Anchorage Grounds § 110.166 York River, Va., naval anchorage. (a) The anchorage grounds. Between Yorktown and the Naval Mine Depot, beginning at latitude 37°15′34″, longitude 76... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false York River, Va., naval anchorage...

  20. 33 CFR 110.166 - York River, Va., naval anchorage.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... ANCHORAGES ANCHORAGE REGULATIONS Anchorage Grounds § 110.166 York River, Va., naval anchorage. (a) The anchorage grounds. Between Yorktown and the Naval Mine Depot, beginning at latitude 37°15′34″, longitude 76... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false York River, Va., naval anchorage...

  1. 33 CFR 110.166 - York River, Va., naval anchorage.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... ANCHORAGES ANCHORAGE REGULATIONS Anchorage Grounds § 110.166 York River, Va., naval anchorage. (a) The anchorage grounds. Between Yorktown and the Naval Mine Depot, beginning at latitude 37°15′34″, longitude 76... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false York River, Va., naval anchorage...

  2. 33 CFR 110.166 - York River, Va., naval anchorage.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ANCHORAGES ANCHORAGE REGULATIONS Anchorage Grounds § 110.166 York River, Va., naval anchorage. (a) The anchorage grounds. Between Yorktown and the Naval Mine Depot, beginning at latitude 37°15′34″, longitude 76... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false York River, Va., naval anchorage...

  3. 33 CFR 110.166 - York River, Va., naval anchorage.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ANCHORAGES ANCHORAGE REGULATIONS Anchorage Grounds § 110.166 York River, Va., naval anchorage. (a) The anchorage grounds. Between Yorktown and the Naval Mine Depot, beginning at latitude 37°15′34″, longitude 76... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false York River, Va., naval anchorage...

  4. Research and Publications in New York State History, 1977.

    ERIC Educational Resources Information Center

    Bielinski, Stefan, Comp.

    This 1977 edition contains references to all New York state history-related works which were either published, completed, or in progress during 1977. Works which presented new knowledge on any aspect of the history of New York state are included. Entries cover books, pamphlets, graduate theses, and journal and magazine articles. Reprints and…

  5. Research and Publications in New York State History, 1976.

    ERIC Educational Resources Information Center

    Bielinski, Stefan, Comp.

    The 1976 edition contains references to all New York State history-related works which were either published, completed, or in progress during 1976. Works are included which presented new knowledge on any aspect of the history of New York State. Entries include books, leaflets, graduate theses, and journal and magazine articles. Newspaper and…

  6. 46 CFR 15.1030 - New York and New Jersey.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false New York and New Jersey. 15.1030 Section 15.1030 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS Vessels in Foreign Trade § 15.1030 New York and New Jersey. The following U.S. navigable waters...

  7. 46 CFR 15.1030 - New York and New Jersey.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false New York and New Jersey. 15.1030 Section 15.1030 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS Vessels in Foreign Trade § 15.1030 New York and New Jersey. The following U.S. navigable waters...

  8. 46 CFR 15.1030 - New York and New Jersey.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false New York and New Jersey. 15.1030 Section 15.1030 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS Vessels in Foreign Trade § 15.1030 New York and New Jersey. The following U.S. navigable waters...

  9. 46 CFR 15.1030 - New York and New Jersey.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false New York and New Jersey. 15.1030 Section 15.1030 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS Vessels in Foreign Trade § 15.1030 New York and New Jersey. The following U.S. navigable waters...

  10. The Solar Energy Consortium of New York Photovoltaic Research and Development Center

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Klein, Petra M.

    2012-10-15

    Project Objective: To lead New York State to increase its usage of solar electric systems. The expected outcome is that appropriate technologies will be made available which in turn will help to eliminate barriers to solar energy usage in New York State. Background: The Solar Energy Consortium has been created to lead New York State research on solar systems specifically directed at doubling the efficiency, halving the cost and reducing the cost of installation as well as developing unique form factors for the New York City urban environment.

  11. Cardiovascular disease hospitalizations in relation to exposure to the September 11, 2001 World Trade Center disaster and posttraumatic stress disorder.

    PubMed

    Jordan, Hannah T; Stellman, Steven D; Morabia, Alfredo; Miller-Archie, Sara A; Alper, Howard; Laskaris, Zoey; Brackbill, Robert M; Cone, James E

    2013-10-24

    A cohort study found that 9/11-related environmental exposures and posttraumatic stress disorder increased self-reported cardiovascular disease risk. We attempted to replicate these findings using objectively defined cardiovascular disease hospitalizations in the same cohort. Data for adult World Trade Center Health Registry enrollees residing in New York State on enrollment and no cardiovascular disease history (n = 46,346) were linked to a New York State hospital discharge-reporting system. Follow-up began at Registry enrollment (2003-2004) and ended at the first cerebrovascular or heart disease (HD) hospitalization, death, or December 31, 2010, whichever was earliest. We used proportional hazards models to estimate adjusted hazard ratios (AHRs) for HD (n = 1151) and cerebrovascular disease (n = 284) hospitalization during 302,742 person-years of observation (mean follow-up, 6.5 years per person), accounting for other factors including age, race/ethnicity, smoking, and diabetes. An elevated risk of HD hospitalization was observed among women (AHR 1.32, 95% CI 1.01 to 1.71) but not men (AHR 1.16, 95% CI 0.97 to 1.40) with posttraumatic stress disorder at enrollment. A high overall level of World Trade Center rescue and recovery-related exposure was associated with an elevated HD hospitalization risk in men (AHR 1.82, 95% CI 1.06 to 3.13; P for trend = 0.05), but findings in women were inconclusive (AHR 3.29, 95% CI 0.85 to 12.69; P for trend = 0.09). Similar associations were observed specifically with coronary artery disease hospitalization. Posttraumatic stress disorder increased the cerebrovascular disease hospitalization risk in men but not in women. 9/11-related exposures and posttraumatic stress disorder appeared to increase the risk of subsequent hospitalization for HD and cerebrovascular disease. This is consistent with findings based on self-reported outcomes.

  12. Chiropractic. New York State.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of the Professions.

    A reference guide to laws, rules, and regulations that govern the chiropractic practice in New York State is presented. After an overview of professional regulation in the state, licensing requirements/procedures for chiropractors are described. Provisions of Title VIII, Articles 130 and 132, of the Education Law are also covered, along with…

  13. 18. Photocopy of Photograph (From Bethlehem Shipbuilding Ltd., New York, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. Photocopy of Photograph (From Bethlehem Shipbuilding Ltd., New York, New York, 1919) C.1918 PHOTOGRAPH OF CONSTRUCTION WORK IN PROGRESS WITH MACHINE SHOP IN BACKGROUND - Union Iron Works Turbine Machine Shop, 2200 Webster Street, Alameda, Alameda County, CA

  14. The Incidence and Prevalence of Systemic Lupus Erythematosus in New York County (Manhattan), New York: The Manhattan Lupus Surveillance Program.

    PubMed

    Izmirly, Peter M; Wan, Isabella; Sahl, Sara; Buyon, Jill P; Belmont, H Michael; Salmon, Jane E; Askanase, Anca; Bathon, Joan M; Geraldino-Pardilla, Laura; Ali, Yousaf; Ginzler, Ellen M; Putterman, Chaim; Gordon, Caroline; Helmick, Charles G; Parton, Hilary

    2017-10-01

    The Manhattan Lupus Surveillance Program (MLSP) is a population-based registry designed to determine the prevalence of systemic lupus erythematosus (SLE) in 2007 and the incidence from 2007 to 2009 among residents of New York County (Manhattan), New York, and to characterize cases by race/ethnicity, including Asians and Hispanics, for whom data are lacking. We identified possible SLE cases from hospital records, rheumatologist records, and administrative databases. Cases were defined according to the American College of Rheumatology (ACR) classification criteria, the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria, or the treating rheumatologist's diagnosis. Rates among Manhattan residents were age-standardized, and capture-recapture analyses were conducted to assess case underascertainment. By the ACR definition, the age-standardized prevalence and incidence rates of SLE were 62.2 and 4.6 per 100,000 person-years, respectively. Rates were ∼9 times higher in women than in men for prevalence (107.4 versus 12.5) and incidence (7.9 versus 1.0). Compared with non-Hispanic white women (64.3), prevalence was higher among non-Hispanic black (210.9), Hispanic (138.3), and non-Hispanic Asian (91.2) women. Incidence rates were higher among non-Hispanic black women (15.7) compared with non-Hispanic Asian (6.6), Hispanic (6.5), and non-Hispanic white (6.5) women. Capture-recapture adjustment increased the prevalence and incidence rates (75.9 and 6.0, respectively). Alternate SLE definitions without capture-recapture adjustment revealed higher age-standardized prevalence and incidence rates (73.8 and 6.2, respectively, by the SLICC definition and 72.6 and 5.0 by the rheumatologist definition) than the ACR definition, with similar patterns by sex and race/ethnicity. The MLSP confirms findings from other registries on disparities by sex and race/ethnicity, provides new estimates among Asians and Hispanics, and provides estimates using the

  15. Cornell University remote sensing program. [New York

    NASA Technical Reports Server (NTRS)

    Liang, T.; Mcnair, A. J.; Philipson, W. R. (Principal Investigator)

    1978-01-01

    The author has identified the following significant results. Available aerial photographs were used to characterize mosquito breeding sites in Oswego County, New York. Numerous wetlands are contained within this county; this area is the only inland area in North America to have confirmed outbreaks of eastern equine encephalitis. This photocharacterization of primary mosquito breeding sites will be used to develop effective spraying. Large scale color and color infrared aerial photographs were used to assess changes in aquatic vegetation that accompanied phosphorus reduction in an eutrophic lake in New York.

  16. Reading in Early Childhood Education; Proceedings of the York College Reading Conference (1st, Jamaica, New York, April 27, 1974). DICTA No. II.

    ERIC Educational Resources Information Center

    Seittelman, Elizabeth E., Ed.

    This booklet provides abstracts of the proceedings of a conference on reading conducted on 27 April 1974 by the Department of Teacher Preparation of York College of the City University of New York. The following conference presentations are discussed: "Reading Readiness--What Do I Believe?" (Lilyan Peters), "Preschool as a Language Laboratory"…

  17. Free and Beautiful: Lucia Chen--New York Public Library

    ERIC Educational Resources Information Center

    Library Journal, 2004

    2004-01-01

    This article details the work of Lucia Chen of the New York Public Library. Lucia Chen combined her two passions--organization and beautification--in her recent project, creating an online version of the New York Public Library's (NYPL) legendary picture collection. Artists ranging from set designers to filmmakers have long used the collection,…

  18. Research and Publications in New York State History, 1979.

    ERIC Educational Resources Information Center

    Bliven, Briane C., Comp.

    This 1979 edition contains briefly annotated references to all New York state history-related works which were either published, completed, or in progress during 1979. Entries were selected on the basis of presenting a new historical viewpoint or making available new knowledge on any aspect of New York history. Entries include books, pamphlets,…

  19. The Forgotten Minority: Asian Americans in New York City.

    ERIC Educational Resources Information Center

    New York State Advisory Committee to the U.S. Commission on Civil Rights, New York.

    Approximately 2.1 percent of New York City's population is Asian American. This report is concerned with the difficulties faced by members of the Chinese, Japanese, Filipino and Korean communities in the areas of immigration, employment, and as a result of media stereotyping of Asians. An overview of individual Asian communities in New York is…

  20. Hazardous Waste Cleanup: Solvents & Petroleum Incorporated in Syracuse, New York

    EPA Pesticide Factsheets

    The Solvents and Petroleum Service, Inc. (SPS) facility is located at 1405 Brewerton Road in Syracuse, New York. The current owner is a distributor of organic and chlorinated solvents to industries in the Central New York region. Solvents are stored in