Statistics for Health Care Management and Administration

Working with Excel
Jossey-Bass Inc.,U.S. (Verlag)
  • 3. Auflage
  • |
  • erschienen am 15. Dezember 2015
  • |
  • 560 Seiten
E-Book | ePUB mit Adobe DRM | Systemvoraussetzungen
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978-1-118-71264-1 (ISBN)
The must-have statistics guide for students of health services
Statistics for Health Care Management and Administration is a unique and invaluable resource for students of health care administration and public health. The book introduces students to statistics within the context of health care, focusing on the major data and analysis techniques used in the field. All hands-on instruction makes use of Excel, the most common spreadsheet software that is ubiquitous in the workplace. This new third edition has been completely retooled, with new content on proportions, ANOVA, linear regression, chi-squares, and more, Step-by-step instructions in the latest version of Excel and numerous annotated screen shots make examples easy to follow and understand.
Familiarity with statistical methods is essential for health services professionals and researchers, who must understand how to acquire, handle, and analyze data. This book not only helps students develop the necessary data analysis skills, but it also boosts familiarity with important software that employers will be looking for.
* Learn the basics of statistics in the context of Excel
* Understand how to acquire data and display it for analysis
* Master various tests including probability, regression, and more
* Turn test results into usable information with proper analysis
Statistics for Health Care Management and Administration gets students off to a great start by introducing statistics in the workplace context from the very beginning.
3. Auflage
  • Englisch
  • New York, NY
  • |
  • USA
John Wiley & Sons Inc
  • Für Beruf und Forschung
  • 19,58 MB
978-1-118-71264-1 (9781118712641)
1118712641 (1118712641)
weitere Ausgaben werden ermittelt
JOHN F. KROS, PHD, is the Vincent K. McMahon Distinguished Professor of Business in the Marketing and Supply Chain Management Departmentin the College of Business at East Carolina University.
DAVID A. ROSENTHAL, PHD, is Professor and Chair of Health Care Management at Baptist Memorial College of Health Sciences.
1 - Cover???????????????????????? [Seite 1]
2 - Title Page?????????????????????????????????? [Seite 5]
3 - Copyright???????????????????????????????? [Seite 6]
4 - Contents?????????????????????????????? [Seite 7]
5 - Preface???????????????????????????? [Seite 15]
5.1 - Introducing Excel [Seite 15]
5.2 - So How Did We Get to Here? [Seite 15]
5.3 - Intended Level of the Textbook [Seite 16]
5.4 - Textbook Organization [Seite 16]
5.5 - Leading by Example(s) [Seite 17]
6 - Acknowledgments???????????????????????????????????????????? [Seite 19]
7 - The Authors???????????????????????????????????? [Seite 21]
8 - Part 1?????????????????????????? [Seite 25]
8.1 - Chapter 1 Statistics and Excel?????????????????????????????????????????????????????????????????????????? [Seite 27]
8.1.1 - 1.1 How This Book Differs from Other Statistics Texts???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 27]
8.1.2 - 1.2 Statistical Applications in Health Policy and Health Administration???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 28]
8.1.3 - Exercises for Section 1.2???????????????????????????????????????????????????????????????? [Seite 38]
8.1.4 - 1.3 What Is the "Big Picture"??????????????????????????????????????????????????????????????????????????? [Seite 39]
8.1.5 - 1.4 Some Initial Definitions?????????????????????????????????????????????????????????????????????? [Seite 40]
8.1.6 - Exercises for Section 1.4???????????????????????????????????????????????????????????????? [Seite 50]
8.1.7 - 1.5 Five Statistical Tests [Seite 52]
8.1.8 - Exercises for Section 1.5???????????????????????????????????????????????????????????????? [Seite 54]
8.1.9 - Key Terms???????????????????????????????? [Seite 55]
8.2 - Chapter 2 Excel as a Statistical Tool???????????????????????????????????????????????????????????????????????????????????????? [Seite 57]
8.2.1 - 2.1 The Basics?????????????????????????????????????????? [Seite 57]
8.2.2 - Exercises for Section 2.1???????????????????????????????????????????????????????????????? [Seite 59]
8.2.3 - 2.2 Working and Moving Around in a Spreadsheet?????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 60]
8.2.4 - Exercises for Section 2.2???????????????????????????????????????????????????????????????? [Seite 65]
8.2.5 - 2.3 Excel Functions???????????????????????????????????????????????????? [Seite 65]
8.2.6 - Exercises for Section 2.3???????????????????????????????????????????????????????????????? [Seite 70]
8.2.7 - 2.4 The =IF() Function?????????????????????????????????????????????????????????? [Seite 71]
8.2.8 - Exercises for Section 2.4???????????????????????????????????????????????????????????????? [Seite 74]
8.2.9 - 2.5 Excel Graphs?????????????????????????????????????????????? [Seite 75]
8.2.10 - Exercises for Section 2.5???????????????????????????????????????????????????????????????? [Seite 80]
8.2.11 - 2.6 Sorting a String of Data?????????????????????????????????????????????????????????????????????? [Seite 81]
8.2.12 - Exercise for Section 2.6?????????????????????????????????????????????????????????????? [Seite 84]
8.2.13 - 2.7 The Data Analysis Pack?????????????????????????????????????????????????????????????????? [Seite 85]
8.2.14 - 2.8 Functions That Give Results in More than One Cell???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 87]
8.2.15 - Exercises for Section 2.8???????????????????????????????????????????????????????????????? [Seite 90]
8.2.16 - 2.9 The Dollar Sign ($) Convention for Cell References?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 91]
8.2.17 - Key Terms???????????????????????????????? [Seite 93]
8.3 - Chapter 3 Data Acquisition: Sampling and Data Preparation???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 95]
8.3.1 - 3.1 The Nature of Data?????????????????????????????????????????????????????????? [Seite 95]
8.3.2 - Exercises for Section 3.1???????????????????????????????????????????????????????????????? [Seite 102]
8.3.3 - 3.2 Sampling?????????????????????????????????????? [Seite 103]
8.3.4 - Exercises for Section 3.2???????????????????????????????????????????????????????????????? [Seite 117]
8.3.5 - 3.3 Data Access and Preparation???????????????????????????????????????????????????????????????????????????? [Seite 118]
8.3.6 - Exercises for Section 3.3???????????????????????????????????????????????????????????????? [Seite 131]
8.3.7 - 3.4 Missing Data?????????????????????????????????????????????? [Seite 132]
8.3.8 - Key Terms [Seite 134]
8.4 - Chapter 4 Data Display: Descriptive Presentation, Excel Graphing Capability???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 135]
8.4.1 - 4.1 Creating, Displaying, and Understanding Frequency Distributions???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 135]
8.4.2 - Exercises for Section 4.1???????????????????????????????????????????????????????????????? [Seite 153]
8.4.3 - 4.2 Using the Pivot Table to Generate Frequencies of Categorical Variables?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 155]
8.4.4 - Exercises for Section 4.2???????????????????????????????????????????????????????????????? [Seite 159]
8.4.5 - 4.3 A Logical Extension of the Pivot Table: Two Variables???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 159]
8.4.6 - Exercises for Section 4.3???????????????????????????????????????????????????????????????? [Seite 164]
8.4.7 - Key Terms???????????????????????????????? [Seite 164]
8.5 - Chapter 5 Basic Concepts of Probability???????????????????????????????????????????????????????????????????????????????????????????? [Seite 165]
8.5.1 - 5.1 Some Initial Concepts and Definitions???????????????????????????????????????????????????????????????????????????????????????????????? [Seite 165]
8.5.2 - Exercises for Section 5.1???????????????????????????????????????????????????????????????? [Seite 174]
8.5.3 - 5.2 Marginal Probabilities, Joint Probabilities, and Conditional Probabilities?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 174]
8.5.4 - Exercises for Section 5.2???????????????????????????????????????????????????????????????? [Seite 184]
8.5.5 - 5.3 Binomial Probability?????????????????????????????????????????????????????????????? [Seite 185]
8.5.6 - Exercises for Section 5.3???????????????????????????????????????????????????????????????? [Seite 195]
8.5.7 - 5.4 The Poisson Distribution?????????????????????????????????????????????????????????????????????? [Seite 197]
8.5.8 - Exercises for Section 5.4???????????????????????????????????????????????????????????????? [Seite 202]
8.5.9 - 5.5 The Normal Distribution???????????????????????????????????????????????????????????????????? [Seite 202]
8.5.10 - Key Terms???????????????????????????????? [Seite 205]
8.6 - Chapter 6 Measures of Central Tendency and Dispersion: Data Distributions???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 207]
8.6.1 - 6.1 Measures of Central Tendency and Dispersion???????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 207]
8.6.2 - Exercises for Section 6.1???????????????????????????????????????????????????????????????? [Seite 220]
8.6.3 - 6.2 The Distribution of Frequencies???????????????????????????????????????????????????????????????????????????????????? [Seite 221]
8.6.4 - Exercises for Section 6.2???????????????????????????????????????????????????????????????? [Seite 232]
8.6.5 - 6.3 The Sampling Distribution of the Mean???????????????????????????????????????????????????????????????????????????????????????????????? [Seite 233]
8.6.6 - Exercises for Section 6.3???????????????????????????????????????????????????????????????? [Seite 243]
8.6.7 - 6.4 Mean and Standard Deviation of a Discrete Numerical Variable?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 244]
8.6.8 - Exercises for Section 6.4???????????????????????????????????????????????????????????????? [Seite 246]
8.6.9 - 6.5 The Distribution of a Proportion?????????????????????????????????????????????????????????????????????????????????????? [Seite 246]
8.6.10 - Exercises for Section 6.5???????????????????????????????????????????????????????????????? [Seite 251]
8.6.11 - 6.6 The t Distribution?????????????????????????????????????????????????????????? [Seite 251]
8.6.12 - Exercises for Section 6.6???????????????????????????????????????????????????????????????? [Seite 256]
8.6.13 - Key Terms???????????????????????????????? [Seite 257]
9 - Part 2?????????????????????????? [Seite 259]
9.1 - Chapter 7 Confidence Limits and Hypothesis Testing?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 261]
9.1.1 - 7.1 What Is a Confidence Interval??????????????????????????????????????????????????????????????????????????????????? [Seite 261]
9.1.2 - Exercises for Section 7.1???????????????????????????????????????????????????????????????? [Seite 267]
9.1.3 - 7.2 Calculating Confidence Limits for Multiple Samples?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 268]
9.1.4 - Exercises for Section 7.2???????????????????????????????????????????????????????????????? [Seite 270]
9.1.5 - 7.3 What Is Hypothesis Testing????????????????????????????????????????????????????????????????????????????? [Seite 271]
9.1.6 - Exercises for Section 7.3???????????????????????????????????????????????????????????????? [Seite 273]
9.1.7 - 7.4 Type I and Type II Errors???????????????????????????????????????????????????????????????????????? [Seite 274]
9.1.8 - Exercises for Section 7.4???????????????????????????????????????????????????????????????? [Seite 290]
9.1.9 - 7.5 Selecting Sample Sizes?????????????????????????????????????????????????????????????????? [Seite 291]
9.1.10 - Exercises for Section 7.5???????????????????????????????????????????????????????????????? [Seite 293]
9.1.11 - Key Terms???????????????????????????????? [Seite 294]
9.2 - Chapter 8 Statistical Tests for Categorical Data?????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 295]
9.2.1 - 8.1 Independence of Two Variables???????????????????????????????????????????????????????????????????????????????? [Seite 295]
9.2.2 - Exercises for Section 8.1???????????????????????????????????????????????????????????????? [Seite 306]
9.2.3 - 8.2 Examples of Chi-Square Analyses???????????????????????????????????????????????????????????????????????????????????? [Seite 307]
9.2.4 - Exercises for Section 8.2???????????????????????????????????????????????????????????????? [Seite 313]
9.2.5 - 8.3 Small Expected Values in Cells?????????????????????????????????????????????????????????????????????????????????? [Seite 314]
9.2.6 - Exercises for Section 8.3???????????????????????????????????????????????????????????????? [Seite 316]
9.2.7 - Key Terms???????????????????????????????? [Seite 317]
9.3 - Chapter 9 t Tests for Related and Unrelated Data?????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 319]
9.3.1 - 9.1 What Is a t Test????????????????????????????????????????????????????????? [Seite 319]
9.3.2 - Exercises for Section 9.1???????????????????????????????????????????????????????????????? [Seite 326]
9.3.3 - 9.2 A t Test for Comparing Two Groups???????????????????????????????????????????????????????????????????????????????????????? [Seite 327]
9.3.4 - Exercises for Section 9.2???????????????????????????????????????????????????????????????? [Seite 340]
9.3.5 - 9.3 A t Test for Related Data???????????????????????????????????????????????????????????????????????? [Seite 342]
9.3.6 - Exercises for Section 9.3???????????????????????????????????????????????????????????????? [Seite 345]
9.3.7 - Key Terms???????????????????????????????? [Seite 345]
9.4 - Chapter 10 Analysis of Variance???????????????????????????????????????????????????????????????????????????? [Seite 347]
9.4.1 - 10.1 One-Way Analysis of Variance???????????????????????????????????????????????????????????????????????????????? [Seite 347]
9.4.2 - Exercises for Section 10.1?????????????????????????????????????????????????????????????????? [Seite 363]
9.4.3 - 10.2 ANOVA for Repeated Measures?????????????????????????????????????????????????????????????????????????????? [Seite 364]
9.4.4 - Exercises for Section 10.2?????????????????????????????????????????????????????????????????? [Seite 372]
9.4.5 - 10.3 Factorial Analysis of Variance???????????????????????????????????????????????????????????????????????????????????? [Seite 373]
9.4.6 - Exercises for Section 10.3?????????????????????????????????????????????????????????????????? [Seite 386]
9.4.7 - Key Terms???????????????????????????????? [Seite 388]
9.5 - Chapter 11 Simple Linear Regression???????????????????????????????????????????????????????????????????????????????????? [Seite 389]
9.5.1 - 11.1 Meaning and Calculation of Linear Regression???????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 389]
9.5.2 - Exercises for Section 11.1?????????????????????????????????????????????????????????????????? [Seite 397]
9.5.3 - 11.2 Testing the Hypothesis of Independence???????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 398]
9.5.4 - Exercises for Section 11.2?????????????????????????????????????????????????????????????????? [Seite 404]
9.5.5 - 11.3 The Excel Regression Add-In?????????????????????????????????????????????????????????????????????????????? [Seite 405]
9.5.6 - Exercises for Section 11.3?????????????????????????????????????????????????????????????????? [Seite 412]
9.5.7 - 11.4 The Importance of Examining the Scatterplot?????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 412]
9.5.8 - 11.5 The Relationship between Regression and the t Test???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 415]
9.5.9 - Exercises for Section 11.5?????????????????????????????????????????????????????????????????? [Seite 416]
9.5.10 - Key Terms???????????????????????????????? [Seite 417]
9.6 - Chapter 12 Multiple Regression: Concepts and Calculation?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 419]
9.6.1 - 12.1 Introduction???????????????????????????????????????????????? [Seite 419]
9.6.2 - Exercises for Section 12.1?????????????????????????????????????????????????????????????????? [Seite 430]
9.6.3 - Key Terms???????????????????????????????? [Seite 431]
9.7 - Chapter 13 Extensions of Multiple Regression?????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 433]
9.7.1 - 13.1 Dummy Variables in Multiple Regression???????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 433]
9.7.2 - Exercises for Section 13.1?????????????????????????????????????????????????????????????????? [Seite 444]
9.7.3 - 13.2 The Best Regression Model?????????????????????????????????????????????????????????????????????????? [Seite 445]
9.7.4 - Exercises for Section 13.2?????????????????????????????????????????????????????????????????? [Seite 455]
9.7.5 - 13.3 Correlation and Multicolinearity???????????????????????????????????????????????????????????????????????????????????????? [Seite 456]
9.7.6 - Exercises for Section 13.3?????????????????????????????????????????????????????????????????? [Seite 459]
9.7.7 - 13.4 Nonlinear Relationships?????????????????????????????????????????????????????????????????????? [Seite 459]
9.7.8 - Exercises for Section 13.4?????????????????????????????????????????????????????????????????? [Seite 471]
9.7.9 - Key Terms???????????????????????????????? [Seite 472]
9.8 - Chapter 14 Analysis with a Dichotomous Categorical Dependent Variable???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 473]
9.8.1 - 14.1 Introduction to the Dichotomous Dependent Variable???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 474]
9.8.2 - 14.2 An Example with a Dichotomous Dependent Variable: Traditional Treatments???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 475]
9.8.3 - Exercises for Section 14.2?????????????????????????????????????????????????????????????????? [Seite 486]
9.8.4 - 14.3 Logit for Estimating Dichotomous Dependent Variables???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 487]
9.8.5 - Exercises for Section 14.3?????????????????????????????????????????????????????????????????? [Seite 499]
9.8.6 - 14.4 A Comparison of Ordinary Least Squares, Weighted Least Squares, and Logit?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 500]
9.8.7 - Exercises for Section 14.4?????????????????????????????????????????????????????????????????? [Seite 504]
9.8.8 - Key Terms???????????????????????????????? [Seite 504]
9.9 - Appendix A Multiple Regression and Matrices [Seite 505]
9.9.1 - An Introduction to Matrix Math?????????????????????????????????????????????????????????????????????????? [Seite 505]
9.9.2 - Addition and Subtraction of Matrices?????????????????????????????????????????????????????????????????????????????????????? [Seite 506]
9.9.3 - Multiplication of Matrices?????????????????????????????????????????????????????????????????? [Seite 507]
9.9.4 - Matrix Multiplication and Scalars???????????????????????????????????????????????????????????????????????????????? [Seite 508]
9.9.5 - Finding the Determinant of a Matrix???????????????????????????????????????????????????????????????????????????????????? [Seite 508]
9.9.6 - Matrix Capabilities of Excel?????????????????????????????????????????????????????????????????????? [Seite 510]
9.9.7 - Explanation of Excel Output Displayed with Scientific Notation?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 513]
9.9.8 - Using the b Coefficients to Generate Regression Results???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 514]
9.9.9 - Calculation of All Multiple Regression Results?????????????????????????????????????????????????????????????????????????????????????????????????????????? [Seite 515]
9.9.10 - Exercises for Appendix A?????????????????????????????????????????????????????????????? [Seite 518]
10 - References?????????????????????????????????? [Seite 521]
11 - Glossary?????????????????????????????? [Seite 523]
12 - Index???????????????????????? [Seite 537]
13 - EULA [Seite 562]

Chapter 1
Statistics and Excel

Learning Objectives

  • Understand how this book differs from other statistics texts
  • Understand how knowledge of statistics may be beneficial to health policy or health administration professionals
  • Understand the "big picture" with regard to the use of statistics for health policy and administration
  • Understand the definitions of the following terms:
    • Populations and samples
    • Random and nonrandom samples
    • Types of random samples
    • Variables, independent and dependent
  • Identify the five separate statistical tests: chi-square test, the t test, analysis of variance (ANOVA), regression analysis, and Logit

Statistics is a subject that for many people is pure tedium. For others, it is more likely to be anathema. Still others find statistics interesting, even stimulating, but they are usually in the minority in any group.

This book is premised on the recognition that in the health care industry, as indeed among people in any industry or discipline, there are at least these three different views of statistics, and that any statistics class is likely to be made up more of the first two groups than the last one. This book provides an introduction to statistics in health policy and administration that is relevant, useful, challenging, and informative.

1.1 How This Book Differs from Other Statistics Texts

The primary difference between this statistics text and most others is that this text uses Microsoft Excel as the tool for carrying out statistical operations and understanding statistical concepts as they relate to health policy and health administration issues. This is not to say that no other statistics texts use Excel. Levine, Stephan, Szabat (2013) have produced a very useable text, Statistics for Managers Using Microsoft Excel. But their book focuses almost exclusively on non-health-related topics. We agree that the closer the applications of statistics are to students' real-life interests and experiences, the more effective students will be in understanding and using statistics. Consequently, this book focuses its examples entirely on subjects that should be immediately familiar to people in the health care industry.

Excel, which most people know as a spreadsheet program for creating budgets, comparing budgeted and expended amounts, and generally fulfilling accounting needs, is also a very powerful statistical tool. Books that do not use Excel for teaching statistics generally leave the question of how to carry out the actual statistical operations in the hands of the student or the instructor. It is often assumed that relatively simple calculations, such as means, standard deviations, and t tests, will be carried out on paper or with a calculator. For more complicated calculations, the assumption is usually that a dedicated statistical package, such as SAS, SPSS, STATA, or SYSTAT, will be used. There are at least two problems with this approach that we hope to overcome in this book. First, calculations done on paper, or even those done with a calculator, can make even simple statistical operations overly tedious and prone to errors in arithmetic. Second, because dedicated statistical packages are designed for use rather than for teaching, they often obscure the actual process of calculating the statistical results, thereby hindering students' understanding of both how the statistic is calculated and what the statistic means.

In general, this is not true of Excel. It is true that when using this book, a certain amount of time must be devoted to the understanding of how to use Excel as a statistical tool. But once that has been done, Excel makes the process of carrying out the statistical procedures under consideration relatively clear and transparent. The student should end up with a better understanding of what the statistic means, through an understanding of how it is calculated, and not simply come away with the ability to get a result by entering a few commands into a statistical package. This is not to say that Excel cannot be used to eliminate many of the steps needed to get particular statistical results. A number of statistical tests and procedures are available as add-ins to Excel. However, using Excel as a relatively powerful-yet transparent-calculator can lead to a much clearer understanding of what a statistic means and how it may be used.

1.2 Statistical Applications in Health Policy and Health Administration

When teaching statistics to health policy and health administration students, we often encounter the same question: "All these statistics are fine, but how do they apply to anything I am concerned with?" The question not only is a reasonable one, but also points directly to one of the most important and difficult challenges for a statistics teacher, a statistics class, or a statistics text. How can it be demonstrated that these statistics have any real relevance to anything that the average person working in the health care industry ever needs to know or do?

To work toward a better understanding of why and when the knowledge of statistics may be useful to someone working in health policy or health administration, we've selected six examples of situations in which statistical applications can play a role. All six of these examples were inspired by real problems faced by students in statistics classes, and they represent real statistical challenges that students have faced and hoped to solve. In virtually every case, the person who presented the problem recognized it as one that could probably be dealt with using some statistical tool. But also in every case, the solution to the problem was not obvious in the absence of some understanding of statistics. Although these case examples are not likely to resonate with every reader, perhaps they will give many readers a little better insight into why knowledge of statistics can be useful.

Documentation of Medicare Reimbursement Claims

The Pentad Home Health Agency provides home health services in five counties of an eastern state. The agency must be certain that its Medicare reimbursement claims are appropriately and correctly documented in order to ensure that Medicare will process these claims and issue benefits in a timely manner. All physician orders, including medications, home visits for physical therapy, home visits of skilled nursing staff, and any other orders for service, must be correctly documented on a Form CMS-485. Poorly or otherwise inadequately prepared documentation can lead to rejection or delay in processing of the claim for reimbursement by the Centers for Medicare and Medicaid Services (CMS).

Pentad serves about 800 clients in the five-county region. In order to assure themselves that all records are properly documented, the administration runs a chart audit of 1 in 10 charts each quarter. The audit seeks to determine (1) whether all orders indicated in the chart have been carried out and (2) if the orders have been correctly documented in the Form CMS-485. Orders that have not been carried out, or orders incorrectly documented, lead to follow-up training and intervention to address these issues and ensure that the orders and documentation are properly prepared going forward.

Historically, the chart audit has been done by selecting each tenth chart, commencing at the beginning or at the end of the chart list. Typically, the chart audit determines that the majority of charts, usually 85 to 95 percent, have been correctly documented. But there are occasionally areas, such as in skilled nursing care, where the percentage of correct documentation may fall below that level. When this happens, the administration initiates appropriate corrective action.

Sampling, Data Display, and Probability

One of the questions of the audit has been the selection of the sample. Because the list of clients changes relatively slowly, the selection of every tenth chart often results in the same charts being selected for audit from one quarter to the next. That being the case, a different strategy for chart selection is desirable. It has been suggested by statisticians that using a strictly random sample of the charts might be a better way to select them for quarterly review, as this selection would have a lesser likelihood of resulting in a review of the same charts from quarter to quarter. But how does one go about drawing a strictly random sample from any population? Or, for that matter, what does "strictly random" actually mean and why is it important beyond the likelihood that the same files may not be picked from quarter to quarter? These questions are addressed by statistics, specifically the statistics associated with sample selection and data collection.

Another question related to the audit concerns when to initiate corrective action. Suppose a sample of 1 in 10 records is drawn (for 800 clients that would be 80 records) and it is discovered that 20 of the records have been incorrectly documented. Twenty of 80 records incorrectly documented would mean that only 75 percent of the records were correctly documented. This would suggest that an intervention should be initiated to correct the documentation problem. But it was a sample of the 800 records that was examined, not the entire 800. Suppose that the 20 incorrectly documented records were, by the luck of the draw, so to speak, the only incorrectly documented records in the entire 800. That would mean that only 2.5 percent of the cases were incorrectly documented.

If the required...

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