Category: Research

MANAGED CARE ORGANISATIONS

Managed care organisations
Managed care organisations

MANAGED CARE ORGANISATIONS

Order Instructions:

As your third assignment toward completion of the Session Long Project you are asked to review the paper by A. Mains, A. Coustasse, K. Lykens: Physician Incentives: Managed Care and Ethics and answer the questions below.
1.Consider this idea from the paper: “Medicine is a moral enterprise. Because MCOs are involved in the delivery of medical care, they too, are moral entities. However, MCOs are also businesses.”
2.Explain the idea that the authors sought to convey.
3.Discuss the physician’s dual function under an MCO model of care.
4.What concerns do you have about the physician- patient relationship under MCOs?

Module Overview

Basically, managed care and managed care organizations (MCOs) was championed as a powerful force for containing healthcare costs. We will see that this is not necessarily the case. We will also see that managed care brings up a range of structural issues related to price fixing and market power.

In the United States after World War II, healthcare was based on an indemnity model or fee for service. In this case health insurers simply paid the bills for services ordered by physicians. These traditional plans provided few incentives for cost containment medical decisions.

Responding to the lack of cost containment measures in the indemnity model, private insurers began to “manage care” by exerting influence on the decisions made by physicians. Managed care is the process of structuring or restructuring the healthcare system in terms of financing, purchasing, delivering, measuring, and documenting a broad range of healthcare services and products.

Sometimes this process of restructuring took the form of bureaucratic rules, e.g. requiring physicians to seek administrative approval before proceeding with certain procedures. In other cases, financial incentives were used to shape physician behavior. By the mid 1990’s, “managed care” had become the dominant form of private sector health insurance.1

Today managed care organization (MCO) is a general term used to describe any number of health insurance arrangements that are intended to reduce unnecessary healthcare costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; and the intensive management of high-cost healthcare cases.

Managed care organizations are structured with an imperative to consider both the impact on costs and also the impact on doctors’ decisions whether to join their networks.

These considerations by MCOs to both contain costs and attract physicians are influenced by the values and practices that physicians bring to healthcare. Physicians want to earn a living but not at the risk of endangering the lives they are meant to serve. These healthcare values held by physicians pose a strategic dilemma for managed care organizations needing to contain costs and attract physicians to assemble provider networks.

Low cost MCOs with contract restrictions on spending are seen as highly restrictive. On the other hand, MCOs with large physician networks write cost containment rules into contracts that are not overly burdensome.

It is interesting to think about how MCOs balance competing interests and ethical issues in cost containment, physician ideals, and quality of care.

There are a wide variety of managed care models that integrate financing and management with the delivery of healthcare services to an enrolled population.

Health Maintenance Organizations: HMOs are organized healthcare systems that are responsible for both the financing and the delivery of a broad range of comprehensive health services to an enrolled population. HMOs act both as insurer and provider of healthcare services. They charge employers a fixed premium for each subscriber. An independent practice association (IPA)-model HMO provides medical care to its subscribers through contracts it establishes with independent physicians. In a staff-model HMO, the physicians would normally be full-time employees of the HMO. Individuals who subscribe to an HMO are often limited to the panel of physicians who have contracted with the HMO to provide services to its subscribers.

Preferred provider organizations (PPOs) are entities through which employer health benefit plans and health insurance carriers contract to purchase healthcare services for covered beneficiaries from a selected group of participating providers. Most states have specific PPO laws that directly regulate such entities.

Exclusive provider organizations (EPOs) limit their beneficiaries to participating providers for any healthcare services. EPOs use a gatekeeper approach to authorize non–primary care services. The primary difference between an HMO and an EPO is that the former is regulated under HMO laws and regulations, whereas the latter is regulated under insurance laws and regulations.

These integrated health delivery organizations raise a variety of issues with the Department of Justice and the Federal Trade Commission. The issues include price fixing and antitrust problems based on market power.

Depending on how the groups are organized- horizontal versus vertical- and who is integrated- competing physician groups or a multi provider network a MCO may violate several antitrust laws.

Whenever an MCO possesses significant market power or deals with a group that has significant market power, antitrust implications should be considered. To determine market power, it is necessary first to identify the market in which the entity exercises power. For antitrust purposes, the relevant market has two components: (1) a product component and (2) a geographic component.

Price fixing is considered a per se violation of the antitrust laws. Per Se Violations conclusively violate antitrust laws and means there is no further investigation of its effects on the competitiveness of the market because its intentions are so obvious. A Per Se Violation would almost always limit competition and decrease productivity. Activities that fall under per se violations are acts such as horizontal price fixing and horizontal market division.

Price fixing occurs when two or more competitors come together to decide on a price that will be charged for services or goods. The per se rule applies to restraints in trade that are so inimical to competition and so unjustified that they are presumed to be unreasonable and, therefore, are illegal.

Aaron, Henry J. and Reischauer, Robert D., (1995) “The Medicare Reform Debate: What is the Next Step?” Health Affiars. 14:4. p.8-30

Required Reading

D.A. Mains, A. Coustasse, K. Lykens: Physician Incentives: Managed Care and Ethics. The Internet Journal of Law, Healthcare and Ethics. 2004 Volume 2 Number 1. DOI: 10.5580/24ae – See more at: http://ispub.com/IJLHE/2/1/12416

Managed Care and Physician Incentives: The Effects of Competition on the Cost and Quality of Care. David J. Cooper and James B. Rebitzer. March 2004. http://myweb.fsu.edu/djcooper/research/managedcare.pdf

Government Agencies Soften Stance on What Constitutes Price Fixing. David A. Ettinger and Mark L. Lasser (March, 2008) http://corporate.findlaw.com/litigation-disputes/government-agencies-soften-stance-on-what-constitutes-price.html

Diagnosing Physician-Hospital Organizations. Susan A. Creighton. Federal Trade Commission Remarks Before American Health Lawyers Association, Program on Legal Issues Affecting Academic Medical Centers and Other Teaching Institutions. January 22, 2004. Washington, DC. Retrieved from: http://www.ftc.gov/public-statements/2004/01/diagnosing-physician-hospital-organizations

Statement of department of justice and federal trade commission enforcement policy on multiprovider networks; Federal Trade Commission; Competition in The Healthcare Market place; Statements of Health Care Antitrust Enforcement Policy; Statement 9. (July 8, 2009). Retrieved from: http://www.law.uh.edu/faculty/jmantel/health-law/Statement9AntitrustEnforcementPolicy.pdf

The above policy has been updated (Statement 9 on Multi-provider Network), Read the updates below:

Revised Statements on Multi-provider networks: http://corporate.findlaw.com/law-library/revised-policy-statements-on-health-care-antitrust-enforcement.html

Optional Reading

Competition in the healthcare marketplace. http://www.ftc.gov/bc/healthcare/antitrust/index.htm

Improving Health Care: A Dose of Competition: A Report by the Federal Trade Commission and the Department of Justice (July 2004). http://www.ftc.gov/reports/healthcare/healthcarerptexecsum.pdf

QuickCounsel Antitrust: U.S. Laws and Regulations. Elizabeth Killingsworth, Esq. http://www.acc.com/legalresources/quickcounsel/auslar.cfm

SAMPLE ANSWER

MANAGED CARE ORGANISATIONS

“Medicine is a moral enterprise. Because MCOs are involved in the delivery of medical care, they too are moral entities. However, MCOs are also businesses.”

MCOs are moral entities because they aim at deliver quality, safe and effective medical care. They are responsible of doing what is right and best for the service users while ensuring equitable distribution of the scarce health resources. However, the managed care control changes the patient physician relationship to a business-consumer relationship.  This implies that the main goal  of MCOs is to ensure that   physicians adopts  the principle of distributive ethic; which is basically  providing the most safe and best quality of care to the greatest number of patients as possible using the allotted budget or incurring losses (Mains, Coustasse, & Lykens, 2004).

Under this moral obligation, the MCOs are guided by the utilitarianism- which basically entails performing the best action that maximizes utility.  However, the MCOs are economic tenets that aim at reducing costs for service users and aims at generating profit simultaneously. Therefore, when making decisions regarding MCOs, providers should consider the economic effects when maintaining aggregating costs of care so as to avoid loses in either the MCOs or the physicians. This involves establishing control, incentives, bonuses, and withholds as well as other quality assurance initiatives that will ensure that physician practices are safe, quality and profit generating (Cooper and Rebitzer, 2004).

Physician dual function

In managed care, the physicians have dual functions namely a) patient fiduciary and b) Financial advocates. The physician play the unrestricted role of patient advocates by ensuring that the managed care model puts into consideration to patient’s autonomy, respects it, and exercise the ethical principle of beneficence. This implies that the physicians are patient’s advocates in voicing their concerns whenever the managed care model prioritizes its benefits over the patient’s interests, or any other good that is beyond establishing effective physician-patient relationship.  This is an important role because the MCOs require expects the physicians to choose the society wellbeing over individual patient’s interest (Mains, Coustasse, & Lykens, 2004).

Therefore, when enrolling in these organizations, it is important for the physicians to understand that their first role is to be patient advocates. Under patient fiduciary role, the physicians are legally responsible for advising patients about all possible alternative care or technological advancement that can be used to manage their illness. The physicians are expected to remain prudent steward when advising and deciding the limits of patient care. This entails balancing between medical merits and financial risks.  Trust, honesty and caring are foundation of establishing effective physician-patient fiduciary relationship (Cooper and Rebitzer, 2004).

Concerns about physician-patient relationship

Managed care is associated with moral and professional ethical dilemmas. For instance, MCOs focus on financial incentives and social optimal outcomes instead of single patient well-being. This brings forth the concept of “countervailing agency” which is basically the physician’s role to choose between individual patient’s interests and the society wellbeing.  If a patient does not receive care as by MCOs, the physicians can be sued for malpractice. This puts the physicians at dilemma of delivering care based on MCOs expectations and risk for liability (Mains, Coustasse, & Lykens, 2004).

In addition, the MCOs emphasize on utilitarianism approach when solving the healthcare expenditure.  Despite its advantages, this approach raises concerns of its validity and morality in physician- patient relationship. The professional sovereignty vs. physician financial incentives complex interaction results into a conflict of interest. It is important for the managers in healthcare system to choose a strategy that helps them identify how to favor the interests of the patients and the society.  This calls for reforms to re-define the moral mission for MCOs to fulfill their goals and to preserve efficient physician-patient relationship ( Improving Health Care, 2004).

References

Cooper, D.J., and Rebitzer, J.B. (2004). Managed Care and Physician Incentives The Effects of Competition on the Cost and Quality of Care. Retrieved from http://myweb.fsu.edu/djcooper/research/managedcare.pdf                                                                       

Mains, D.A., Coustasse, A., & Lykens, C.K. (2004). Physician Incentives: Managed Care and Ethics. The Internet Journal of Law, Healthcare and Ethics. Volume 2 Number 1. DOI: 10.5580/24ae – Retrieved from http://ispub.com/IJLHE/2/1/12416

Improving Health Care (2004). A Dose of Competition: A Report by the Federal Trade Commission and the Department of Justice. Retrieved from http://www.ftc.gov/reports/healthcare/healthcarerptexecsum.pdf

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Analysis of FCT Act research paper

 

Analysis of FCT Act
Analysis of FCT Act

Analysis of FCT Act

Order Instructions:

Case Assignment

A physician-hospital organization (PHO) consists of 15 hospitals – with 2,247 staffed beds – and approximately 500 physicians. The PHO operates in a very large section of south Georgia, including the cities of Valdosta, Tifton, Thomasville, Moultrie, and Waycross. The PHOs’ physician members represent approximately 90 percent of all physicians practicing in the region.

The PHO served as a vehicle through which competing hospitals and physicians could bargain collectively with health plans to obtain higher fees for themselves. The owner PHOs, member hospitals, and member physicians canceled contracts with payors and informed them that the PHO would be the sole entity through which they would enter into payor contracts. To contract with the PHO, payors allegedly have had to accept the fixed physician fee schedule and fixed discount of no more than 10 percent off hospital list prices.
1.Explain why this arrangement would be found “per se” illegal under the FTCs’ analysis.
2.What kind of actions could be taken to restructure this arrangement to avoid a determination that it is per se illegal?
3.Discuss the alternate FTC analysis that is applied to such cases if they are suspect but not found to be per se illegal.

Module Overview

Basically, managed care and managed care organizations (MCOs) was championed as a powerful force for containing healthcare costs. We will see that this is not necessarily the case. We will also see that managed care brings up a range of structural issues related to price fixing and market power.

In the United States after World War II, healthcare was based on an indemnity model or fee for service. In this case health insurers simply paid the bills for services ordered by physicians. These traditional plans provided few incentives for cost containment medical decisions.

Responding to the lack of cost containment measures in the indemnity model, private insurers began to “manage care” by exerting influence on the decisions made by physicians. Managed care is the process of structuring or restructuring the healthcare system in terms of financing, purchasing, delivering, measuring, and documenting a broad range of healthcare services and products.

Sometimes this process of restructuring took the form of bureaucratic rules, e.g. requiring physicians to seek administrative approval before proceeding with certain procedures. In other cases, financial incentives were used to shape physician behavior. By the mid 1990’s, “managed care” had become the dominant form of private sector health insurance.1

Today managed care organization (MCO) is a general term used to describe any number of health insurance arrangements that are intended to reduce unnecessary healthcare costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; and the intensive management of high-cost healthcare cases.

Managed care organizations are structured with an imperative to consider both the impact on costs and also the impact on doctors’ decisions whether to join their networks.

These considerations by MCOs to both contain costs and attract physicians are influenced by the values and practices that physicians bring to healthcare. Physicians want to earn a living but not at the risk of endangering the lives they are meant to serve. These healthcare values held by physicians pose a strategic dilemma for managed care organizations needing to contain costs and attract physicians to assemble provider networks.

Low cost MCOs with contract restrictions on spending are seen as highly restrictive. On the other hand, MCOs with large physician networks write cost containment rules into contracts that are not overly burdensome.

It is interesting to think about how MCOs balance competing interests and ethical issues in cost containment, physician ideals, and quality of care.

There are a wide variety of managed care models that integrate financing and management with the delivery of healthcare services to an enrolled population.

Health Maintenance Organizations: HMOs are organized healthcare systems that are responsible for both the financing and the delivery of a broad range of comprehensive health services to an enrolled population. HMOs act both as insurer and provider of healthcare services. They charge employers a fixed premium for each subscriber. An independent practice association (IPA)-model HMO provides medical care to its subscribers through contracts it establishes with independent physicians. In a staff-model HMO, the physicians would normally be full-time employees of the HMO. Individuals who subscribe to an HMO are often limited to the panel of physicians who have contracted with the HMO to provide services to its subscribers.

Preferred provider organizations (PPOs) are entities through which employer health benefit plans and health insurance carriers contract to purchase healthcare services for covered beneficiaries from a selected group of participating providers. Most states have specific PPO laws that directly regulate such entities.

Exclusive provider organizations (EPOs) limit their beneficiaries to participating providers for any healthcare services. EPOs use a gatekeeper approach to authorize non–primary care services. The primary difference between an HMO and an EPO is that the former is regulated under HMO laws and regulations, whereas the latter is regulated under insurance laws and regulations.

These integrated health delivery organizations raise a variety of issues with the Department of Justice and the Federal Trade Commission. The issues include price fixing and antitrust problems based on market power.

Depending on how the groups are organized- horizontal versus vertical- and who is integrated- competing physician groups or a multi provider network a MCO may violate several antitrust laws.

Whenever an MCO possesses significant market power or deals with a group that has significant market power, antitrust implications should be considered. To determine market power, it is necessary first to identify the market in which the entity exercises power. For antitrust purposes, the relevant market has two components: (1) a product component and (2) a geographic component.

Price fixing is considered a per se violation of the antitrust laws. Per Se Violations conclusively violate antitrust laws and means there is no further investigation of its effects on the competitiveness of the market because its intentions are so obvious. A Per Se Violation would almost always limit competition and decrease productivity. Activities that fall under per se violations are acts such as horizontal price fixing and horizontal market division.

Price fixing occurs when two or more competitors come together to decide on a price that will be charged for services or goods. The per se rule applies to restraints in trade that are so inimical to competition and so unjustified that they are presumed to be unreasonable and, therefore, are illegal.

1Aaron, Henry J. and Reischauer, Robert D., (1995) “The Medicare Reform Debate: What is the Next Step?” Health Affiars. 14:4. p.8-30

Required Reading

D.A. Mains, A. Coustasse, K. Lykens: Physician Incentives: Managed Care and Ethics. The Internet Journal of Law, Healthcare and Ethics. 2004 Volume 2 Number 1. DOI: 10.5580/24ae – See more at: http://ispub.com/IJLHE/2/1/12416

Managed Care and Physician Incentives: The Effects of Competition on the Cost and Quality of Care. David J. Cooper and James B. Rebitzer. March 2004. http://myweb.fsu.edu/djcooper/research/managedcare.pdf

Government Agencies Soften Stance on What Constitutes Price Fixing. David A. Ettinger and Mark L. Lasser (March, 2008) http://corporate.findlaw.com/litigation-disputes/government-agencies-soften-stance-on-what-constitutes-price.html

Diagnosing Physician-Hospital Organizations. Susan A. Creighton. Federal Trade Commission Remarks Before American Health Lawyers Association, Program on Legal Issues Affecting Academic Medical Centers and Other Teaching Institutions. January 22, 2004. Washington, DC. Retrieved from: http://www.ftc.gov/public-statements/2004/01/diagnosing-physician-hospital-organizations

Statement of department of justice and federal trade commission enforcement policy on multiprovider networks; Federal Trade Commission; Competition in The Healthcare Market place; Statements of Health Care Antitrust Enforcement Policy; Statement 9. (July 8, 2009). Retrieved from: http://www.law.uh.edu/faculty/jmantel/health-law/Statement9AntitrustEnforcementPolicy.pdf

The above policy has been updated (Statement 9 on Multi-provider Network), Read the updates below:

Revised Statements on Multi-provider networks: http://corporate.findlaw.com/law-library/revised-policy-statements-on-health-care-antitrust-enforcement.html

Optional Reading

Competition in the healthcare marketplace. http://www.ftc.gov/bc/healthcare/antitrust/index.htm

Improving Health Care: A Dose of Competition: A Report by the Federal Trade Commission and the Department of Justice (July 2004). http://www.ftc.gov/reports/healthcare/healthcarerptexecsum.pdf

QuickCounsel Antitrust: U.S. Laws and Regulations. Elizabeth Killingsworth, Esq. http://www.acc.com/legalresources/quickcounsel/auslar.cfm

SAMPLE ANSWER

Question 1:  Analysis of FCT Act

The health care industry is rapidly changing as it seeks innovative alternatives to control costs and efficiency of the quality studies. There are various types of relationships as well as affiliations that ensure strong competitiveness among other competing healthcare providers. Most of the organizations provide significant competitive benefits to the service users. These multi-provider networks are platforms used by the providers to jointly market the healthcare services to the service users. In most cases, these ventures often contract to reach at predetermined prices in order to contain costs and to assure quality. The contractual relationships among the providers operate and vary greatly. In this statement, the Federal Trade commission (FTC) protects the American consumers through antitrust law (David and Rebitzer, 2004).

The FTC analysis states that it is not illegal “per se” to have a naked arrangement among the providers that predetermine or fix prices so as to allocate markets. Under the FTC’s analysis, the providers are allowed to get into a joint venture if the venture is necessary to achieve precompetitive benefits; and that the outcome of the network is to benefit the consumers. In this case study, the arrangement can be said as illegal “per se” it is evident that the PHO arrangements are unfair, deceptive and seems injurious to consumers because the prices demanded by the PHO is substantially higher than what the physicians and hospitals could have generated if they negotiated unilaterally (Creighton, 2004).

Although setting of the price is necessary and that it is integral to make such arrangements, the PHO have set fixed physician fee and the fixed discount which can be perceived as illegal based on the competitive effects because it negatively influence the vertical (between competing hospitals) and horizontal (between parties and physician) competition. This is because the PHO refused to deal with the individual health plans and instead collectively fixed the prices for the services. Therefore, the PHO was forcing payors to pay higher prices to member healthcare facilities and physicians, which would lead to increased cost of care. Therefore, the HPO arrangements can be viewed as illegal “per se” because: – a) they arranged for collective arrangements of fees and terms of the healthcare plans, b) performed collective negotiations and c) rejected or rather refused  to deal with payors who insisted on their desired terms. These acts are harmful, anticompetitive and desecrated the FCT Act (Ettinger and Lasser, 2008).

Question 2: Actions to restructure this arrangement

It is important to reach a proposed settlement to reach the remedy of this illegal conduct. To start with, the first action is to file a complaint against the HPO, highlighting the FTC Acts that have been violated.  If the complaint is investigated and found to be illegal, the Antitrust Division (DOJ) and Department of Justice will consult and enforce the antitrust laws so as to bring the civil actions. Secondly, it is important for FTC to revise its guidelines and ensure that all the healthcare providers understand the rules. This includes prohibiting respondents from facilitating any agreement between physicians a) to deal or refuse to deal with the payors, b) negotiate with payors on the behalf of physicians, c) determine the terms of deal and d) not deal with any payor individually or collectively.  Another action that can be applied is the use of consent agreement. The consent agreement is meant for settlement purposes. The arrangement is meant to clarify issues of concern and to provide solutions. It does not become part of public records until it becomes accepted by the commission (Ettinger and Lasser, 2008).

Question 3: Alternative FTC analysis

According to the rule of reason and “per se” rule, the existence of monopoly is not an indicator of antitrust laws. There are interpreted statutes that apply to the Supreme Court that permit monopoly. For instance, the rule of reason permits monopoly unless it is achieved or maintained through use of prohibited conduct. Therefore, some acts can be determined as unreasonable per se, while other acts can be subjected to reasoned analysis. Therefore, it is important to examine the anticompetitive behaviors through a reasoned analysis so as to examine its motive, intent and outcome to determine if the action actually support or suppresses market competition (Improving Health Care, 2004).

In addition, in the revised policy statements in Health Care Antitrust Enforcement have introduced flexibility in the antitrust laws for analysis of activities physicians and other integrated networks. The revised policy recognize  the aspect of  “non-financial integration”  in their new guidelines, elaborating on the types of  “risk sharing arrangements” that qualify for financial integration and those that corresponds and fits into the existing antitrust enforcement (Federal Trade Commission, 2008).

References

Creighton, S.A. (2004). Diagnosing Physician-Hospital Organizations. Federal Trade Commission Remarks Before American Health Lawyers Association, Program on Legal Issues Affecting Academic Medical Centers and Other Teaching Institutions.  Washington, DC. Retrieved from: http://www.ftc.gov/public-statements/2004/01/diagnosing-physician-hospital-organizations

David, J., C. and Rebitzer, J.B. (2004). Managed Care and Physician Incentives: The Effects of Competition on the Cost and Quality of Care. Retrieved from http://myweb.fsu.edu/djcooper/research/managedcare.pdf

Ettinger, D. A.,  and Lasser, M. L. (2008). Government Agencies Soften Stance on What Constitutes Price Fixing. Retrieved from http://corporate.findlaw.com/litigation-disputes/government-agencies-soften-stance-on-what-constitutes-price.html

Federal Trade Commission. (2008). Statement of department of justice and federal trade commission enforcement policy on multiprovider networks;; Competition in The Healthcare Market place; Statements of Health Care Antitrust Enforcement Policy; Statement 9. Retrieved from: http://www.law.uh.edu/faculty/jmantel/health-law/Statement9AntitrustEnforcementPolicy.pdf

Improving Health Care (2004). A Dose of Competition: A Report by the Federal Trade Commission and the Department of Justice. Retrieved from http://www.ftc.gov/reports/healthcare/healthcarerptexecsum.pdf

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Create and Analyze Frequency Distributions of Data

Create and Analyze Frequency Distributions of Data Order Instructions:

Create and Analyze Frequency Distributions of Data
Create and Analyze Frequency Distributions of Data

Kindly view the attached files

SAMPLE ANSWER

Module 4 Application Assignment Worksheet

SPSS Frequencies

Instructions

For this assignment, you create and analyze frequency distributions of data provided as a Microsoft Excel file. Import the data into SPSS using the techniques described in Module 3, and then run frequency distribution tables, as instructed below, in SPSS. Note: It is recommended that you save the SPSS data file as you will use the same file for modules 5 and 6 application assignments. Type your answers to all questions directly into the worksheet, and paste the required frequency distributions table at the end of this document.

Create and Analyze Frequency Distributions of Data Research Scenario

A researcher is interested in the effect of a new medication on serum cholesterol, HDL cholesterol, and glycosylated hemoglobin of adults.  The researcher randomly selects a sample of 40 (20 male and 20 female) participants who have been diagnosed with high cholesterol. Assuring equal distribution of males and females, the participants are randomly assigned to one of two conditions (or groups):  Following pretest measures of serum cholesterol (CHOL), High-density lipoprotein cholesterol (HDL), and glycosylated hemoglobin (GLYHB), the experimental group (group 1) is given the medication for a period of six months while the control group (group 2) is given a placebo.  After the six months, CHOL, HDL, and GLYHB are again measured.

 The post-test data for each participant are provided in the data set “Module 4, 5, and 6 application assign data_Cholesterol etc” and can be found in module 4 learning resources. The codebook for the data provided is as follows:

AGE                       Age in years

SEX                         1 =male, 2=female

GROUP 1 =medication, 2=placebo

CHNG_CHOL      change in cholesterol from pre-test to post-test

HDL High-density lipoprotein at post-test

GLYHB                   Glycosylated hemoglobin at post-test

———————————————————————————————————————

Step 1: Import the Microsoft Excel data file into SPSS

Step 2: Create an ungrouped frequency distribution table for each of the following:

AGE, SEX, GROUP, CHNG_CHOL, HDL, and GLYHB   (be sure to save each output and paste into this worksheet document)

 Step 3: Review your SPSS output and answer each of the following questions:

 

QUESTION type answers below
What type of variable is AGE? ________________
What type of variable is SEX? ________________
What type of variable is GROUP? ________________
What type of variable is CHNG_CHOL? ________________
What type of variable is HDL? ________________
How many participants were aged 30-39 years? ________________
What percent of participants were 49 years old or younger? ________________
How many participants had no change in their cholesterol value? ________________
What percent of participants had HDL values of 43 mg/dL? ________________
How many participants had GLYHB values of 4.67 or less? ________________

 

Step 4: Paste each required frequency distribution table below.

Create and Analyze Frequency Distributions of Data Sample Answer

Step 1: Import the Microsoft Excel data file into SPSS

Step 2: Create an ungrouped frequency distribution table for each of the following:

AGE, SEX, GROUP, CHNG_CHOL,H DL, and GLYHB   (be sure to save each output and paste into this worksheet document)

 Step 3: Review your SPSS output and answer each of the following questions:

 

QUESTION type answers below
What type of variable is AGE? Numerical variable:
What type of variable is SEX? Nominal variable
What type of variable is GROUP? Nominal variable
What type of variable is CHNG_CHOL? Numerical variable
What type of variable is HDL? Numerical variable
How many participants were aged 30-39 years? They were 11 participants
What percent of participants were 49 years old or younger? They were 87.5% of participants how were 49 years old or younger.
How many participants had no change in their cholesterol value? 15.00% of the participants had no change in their cholesterol level.
What percent of participants had HDL values of 43 mg/dL? 7.5% of the participants had a HDL values of 43 mg/dL.
How many participants had GLYHB values of 4.67 or less? 45.0% of the participants had a GLYHB values of 4.67 or less.

Step 4: Paste each required frequency distribution table below.

 

Age in years
Frequency Percent Valid Percent Cumulative Percent
Valid 17 1 2.5 2.5 2.5
18 1 2.5 2.5 5.0
20 2 5.0 5.0 10.0
21 1 2.5 2.5 12.5
22 2 5.0 5.0 17.5
23 2 5.0 5.0 22.5
28 2 5.0 5.0 27.5
29 1 2.5 2.5 30.0
31 1 2.5 2.5 32.5
32 2 5.0 5.0 37.5
35 3 7.5 7.5 45.0
37 2 5.0 5.0 50.0
38 2 5.0 5.0 55.0
39 1 2.5 2.5 57.5
41 1 2.5 2.5 60.0
42 1 2.5 2.5 62.5
43 3 7.5 7.5 70.0
44 2 5.0 5.0 75.0
47 1 2.5 2.5 77.5
49 4 10.0 10.0 87.5
50 2 5.0 5.0 92.5
55 1 2.5 2.5 95.0
64 1 2.5 2.5 97.5
65 1 2.5 2.5 100.0
Total 40 100.0 100.0

 

sex
Frequency Percent Valid Percent Cumulative Percent
Valid male 20 50.0 50.0 50.0
female 20 50.0 50.0 100.0
Total 40 100.0 100.0

 

group
Frequency Percent Valid Percent Cumulative Percent
Valid Medication 20 50.0 50.0 50.0
Placebo 20 50.0 50.0 100.0
Total 40 100.0 100.0

 

 

change in cholesterol from pre-test to post-test
Frequency Percent Valid Percent Cumulative Percent
Valid -16 1 2.5 2.5 2.5
-10 3 7.5 7.5 10.0
-9 1 2.5 2.5 12.5
-8 1 2.5 2.5 15.0
-7 2 5.0 5.0 20.0
-6 1 2.5 2.5 22.5
-5 2 5.0 5.0 27.5
-4 3 7.5 7.5 35.0
-3 3 7.5 7.5 42.5
-2 5 12.5 12.5 55.0
-1 6 15.0 15.0 70.0
0 6 15.0 15.0 85.0
1 4 10.0 10.0 95.0
2 2 5.0 5.0 100.0
Total 40 100.0 100.0

 

 

High density lipoprotein at post-test
Frequency Percent Valid Percent Cumulative Percent
Valid 28 1 2.5 2.5 2.5
30 1 2.5 2.5 5.0
33 1 2.5 2.5 7.5
34 2 5.0 5.0 12.5
35 1 2.5 2.5 15.0
36 1 2.5 2.5 17.5
37 1 2.5 2.5 20.0
38 1 2.5 2.5 22.5
39 2 5.0 5.0 27.5
41 3 7.5 7.5 35.0
42 1 2.5 2.5 37.5
43 3 7.5 7.5 45.0
44 2 5.0 5.0 50.0
46 2 5.0 5.0 55.0
47 3 7.5 7.5 62.5
49 3 7.5 7.5 70.0
50 1 2.5 2.5 72.5
51 3 7.5 7.5 80.0
52 1 2.5 2.5 82.5
53 2 5.0 5.0 87.5
54 2 5.0 5.0 92.5
56 1 2.5 2.5 95.0
64 1 2.5 2.5 97.5
69 1 2.5 2.5 100.0
Total 40 100.0 100.0

 

 

Glycosylated hemoglobin at post-test
Frequency Percent Valid Percent Cumulative Percent
Valid 3.41 1 2.5 2.5 2.5
3.94 2 5.0 5.0 7.5
3.98 1 2.5 2.5 10.0
4.25 1 2.5 2.5 12.5
4.31 1 2.5 2.5 15.0
4.33 2 5.0 5.0 20.0
4.44 1 2.5 2.5 22.5
4.47 1 2.5 2.5 25.0
4.52 1 2.5 2.5 27.5
4.53 1 2.5 2.5 30.0
4.59 1 2.5 2.5 32.5
4.63 1 2.5 2.5 35.0
4.64 2 5.0 5.0 40.0
4.67 2 5.0 5.0 45.0
4.77 2 5.0 5.0 50.0
4.81 1 2.5 2.5 52.5
4.84 3 7.5 7.5 60.0
4.87 1 2.5 2.5 62.5
4.97 1 2.5 2.5 65.0
5.00 1 2.5 2.5 67.5
5.12 1 2.5 2.5 70.0
5.14 2 5.0 5.0 75.0
5.26 2 5.0 5.0 80.0
5.28 2 5.0 5.0 85.0
5.78 1 2.5 2.5 87.5
6.22 1 2.5 2.5 90.0
6.72 1 2.5 2.5 92.5
6.75 1 2.5 2.5 95.0
6.99 1 2.5 2.5 97.5
7.72 1 2.5 2.5 100.0
Total 40 100.0 100.0

 

Peritonitis Essay Paper Assignment Available

Peritonitis
Peritonitis

Peritonitis

Order Instructions:

Assignment Instructions
• You will each choose 3 different journal published research study articles that explain the patient’s behavioral and/or psychological responses to having the illness. Do not include articles discussing the physiology or pharmacology of the illness, treatment of the illness or behavioral/psychological responses, or the risk factors for first developing the illness.
• Locate relevant journal published research study articles (these articles need to have been written after 1997 and you must NOT use general literature review articles.
• Choose the 3 articles that best relate to your case study patient.
• Briefly summaries the main topic and focus of each study and include a very summary of the study’s methodology, results, and discussion (i.e. where the authors explain the reasons for their findings and research conclusions) for the articles;
• discuss how each article explicitly and specifically explains the behavioral and psychological responses that the patient in your case study is experiencing in response to their illness.
• Make sure you are using article databases such as PsycINFO, MEDLINE, and CINAHL to run your searches. PsycINFO is likely to find you the most relevant articles for this assignment and all assignments within the behavioral stream. Just using Google or Google Scholar will NOT find you the articles you need. Also, make sure that the search terms you are using will give the databases the best chance of returning the articles you want. If you get no results with one search term, then try another or try and think laterally (e.g. what might be another word for “aggression” that you might find in the literature… hint: what about “irritability”? Or another word for “anxiety” might be “fear” etc.).
• The articles you include must have been published in a journal. Do not include theses, magazines, books or book chapters, letter to the editor or news articles. Academic journals publish all sorts of articles including research studies, book reviews, general literature reviews, editorials/commentaries, letters) but for the articles you include in your Annotated Bibliography you need to use only research study articles. A research study article will describe in detail a qualitative or quantitative research study (e.g., an experiment) including information about the study’s methodology, results, discussion and conclusions. For example, the Module 1 reading Zeilani and Seymour (2012) qualifies as a research study article because the authors describe how they collected and analyzed their data. A Module 3 reading, Lusk and Lash (2005) is a general literature review and does not qualify as a research study as the author does not specify how they went about sourcing information for their article. Lusk and Lash’s article is still a credible and valid source of reference information but it is not a research study and so cannot be used in the Annotated Bibliography assignment.

SAMPLE ANSWER

Peritonitis is a health condition that involves the inflammation of peritoneum (thin protective tissue layer that underlie the abdomen).  This health condition is caused by infection which spreads around the body.  It requires immediate treatment to prevent fatal complications from arising. In patients who have undergone surgical treatment, autonomic responses, mood swings and psychological coping responses are common. This paper explores 3 different journal study articles that explain patient’s behavioral and psychological responses to this illness. This study focuses on behavioral and psychosocial responses following surgical responses.

Boer, K. R., Mahler, C. W., Unlu, C., Lamme, B., Vroom, M. B., Sprangers, M. A., … Boermeester, M. A. (2007). Long-term prevalence of post-traumatic stress disorder symptoms in patients after secondary peritonitis. Critical Care, 11(1), R30.

Introduction/Literature review:  This study investigates the behavioral response following secondary peritonitis. This is because numerous hospital admissions and intensive care unit (ICU) can be physically, emotionally and financially exhaustive. Patients who survive critical illness report critical poor quality of live and symptomology (PTSD) such as numbing, anxiety, loss of avoidant and intrusive recollections. The study suggests that the behavioral interventions are vital in patients with secondary peritonitis.

Methodology:  This is a retrospective cohort   in patients diagnosed with secondary peritonitis. The study comprises of 278 patients who had undergone surgery for secondary peritonitis, where 131 of them were long term survivors. The patients were interviewed Post-traumatic Stress Syndrome 10-question inventory (PTSS-10).

Study/ Results:  The study indicates that in a cohort of 100 patients diagnosed with secondary peritonitis, 86% of them presented with post traumatic stress disorder. PTSD related symptoms were also present in 4.3 times higher in older male patients.

Discussion/explanation: The study indicates that   25% patients who have received surgical treatment for peritonitis are likely to be emotionally and physically upset due to   surgical-related trauma, which could exacerbate illness behavior. The study suggests that patterns of behavior are seen as a product of socio-cultural conditioning and coping strategies. The study suggests that healthcare providers should recognize patient’s responses to various health procedures associated with pain and anxiety.  Other symptoms such as impaired appetite, lack of energy and disturbed sleep can occur due to illness. In addition, some treatments can affect patient’s mood. These conditions can also be aggravated by other environmental factors such as financial strain of lack of physical and emotional support.

Application to the case study: The study findings contribute to the body of research that demonstrates that psychosocial responses in patients are associated with the socio-cultural factors.  The suggests that the healthcare providers should incorporate psychosocial interventions  in routine care so as to help patients such as Mr. Jacobs to manage  stress associated with their new lifestyles of dependency, helplessness and pain. It is important for the healthcare providers to identify and be aware of this hidden morbidity among the patients diagnosed with secondary peritonitis.

Jennifer Finnegan-John and Veronica J. Thomas, “The Psychosocial Experience of Patients with End-Stage Renal Disease and Its Impact on Quality of Life: Findings from a Needs Assessment to Shape a Service,” ISRN Nephrology, vol. 2013, Article ID 308986, 8 pages, 2013. doi:10.5402/2013/308986

Introduction/Literature review: This study investigates the psychosocial experiences in patients with end stage renal disease.  The study conducts needs assessment on renal patients to explore their psychological, spiritual and social needs.  The study objective was to investigate behavioral responses and to conduct needs assessment so as to develop a comprehensive health psychology that can run concurrently with renal counseling.

Methodology:   The study design is prospective qualitative. The study population consisted of 50 patients with end stage renal disease.  The mean age of the participants was 55 years and 40% of them were from black and minority ethnic group.  The study utilized series of semi- structured face to face interviews in renal patients and their carers in order to explore their behavioral and psychological responses and how the disease impacted their quality of life.

Study/ Results:  The study findings indicated that depressive symptoms and disruptive behaviors are common in renal patients.  This is associated with the psychological burden associated with the disease.  Most of the patients in the study had feelings associated with depression and anxiety.

Discussion/explanation: This retrospective study indicates that depression and anxiety is a common behavioral response in patient diagnosed with renal disease. The study suggests that about 25% of patients who are diagnosed with the disease suffer from psychological burden. This behavioral response is associated with emotional numbness, avoidance of social activities and events.  It is also associated difficulty in sleeping, disruptive and reckless behavior and is easily irritated. The study states that these are body responses to stress or perceived threat.

Application to the case study:  The study indicates that depression and anxiety is a behavioral response that goes beyond the mental health. Based on this study, Mr. Jacob’s behavioral responses (irritability, social isolation and binge drinking) could be associated with the emotional burden of the disease. This research is interesting because it suggests that healthcare providers should engage with psychiatrists to help them better manage their improved outcome health.

Mckercher, C.M., Venn, A.J., Blizzard, L., Nelson, M., Palmer, A., Sshby, M., Scott, J., and Jose. M.D. (2012). Psychosocial factors in adults with chronic kidney disease: characteristics of pilot participants in the Tasmanian Chronic Kidney Disease study. BMC Nephrology, 14:83DOI: 10.1186/1471-2369-14-83

Introduction/Literature review: This study investigates behavioral and psychosocial responses in patient diagnosed with chronic illness. The literature links health outcomes with   depression, anxiety and dispositional tendency described by aggression, cynicism attitudes and anger/irritability. The study also indicates that hostility, anger and depression are related with renal failure experiences. According to this study, these psychosocial responses are controlled by biomedical risk factors, and are associated with most aspects of immune function.

Methodology:  This study design is quantitative. The study consisted of 105  patients above 18 years diagnosed with stage 4 CKD and was not under dialysis. The measures used in this study include depression (9- item patient Health questionnaire) and Beck Anxiety Inventory to investigate behavioral responses with disease progression and patient’s quality of life.

Study/ Results:  The study findings indicated that hostility and patient’s behavioral responses to chronic disease are correlated with their plasma levels of CRP. The study findings indicated that the cycle of inflammation levels influence depressive behavior, indicating that depression is problematic indicator of  patients under chronic pain.

Discussion/explanation: The longitudinal study findings indicated that there is a relationship between the CRP levels and psychosocial factors. The study also states that hormonal changes also induce inflammatory processes which in turn influence psychosocial responses. For instance, pain initiates systemic stress which activates neuro-endocrinological pathways (hypothalamic-pituitary-adrenal axis) leading to the secretion of stress hormone.  Accumulation of stress hormone is associated with hostility and depressive symptoms. The study also suggests that genetic predispositions play a major role in both inflammation and hostility.

Application to the case study: The study findings contribute to the body of research that demonstrates that psychosocial responses in patients are associated with systemic inflammation. This indicates that the Mr. Jacob’s depressive behavior (irritability, social isolation and binge drinking) is associated with elevated levels of the systemic inflammation. This research is interesting because it suggests that healthcare providers should reduce systemic inflammation so as to improve patient’s ability to improve pain, and to help them cope with the illness-induced stress in their lives.

References

Boer, K. R., Mahler, C. W., Unlu, C., Lamme, B., Vroom, M. B., Sprangers, M. A., … Boermeester, M. A. (2007). Long-term prevalence of post-traumatic stress disorder symptoms in patients after secondary peritonitis. Critical Care, 11(1), R30. Retrieved from http://doi.org/10.1186/cc5710

Jennifer Finnegan-John and Veronica J. Thomas, “The Psychosocial Experience of Patients with End-Stage Renal Disease and Its Impact on Quality of Life: Findings from a Needs Assessment to Shape a Service,” ISRN Nephrology, vol. 2013, Article ID 308986, 8 pages, 2013. doi:10.5402/2013/308986

Mckercher, C.M., Venn, A.J., Blizzard, L., Nelson, M., Palmer, A., Sshby, M., Scott, J., and Jose. M.D. (2012). Psychosocial factors in adults with chronic kidney disease: characteristics of pilot participants in the Tasmanian Chronic Kidney Disease study. BMC Nephrology, 14:83DOI: 10.1186/1471-2369-14-83

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Future Manpower Needs of the UK Oil and Gas Industry

Future Manpower Needs of the UK Oil and Gas Industry Order Instructions: This is the continuation of job #114727. I will upload the Data Analysis of :
1) Indirect, Direct, Induced employment vs Oil price.

ii) Indirect, Direct, Induced employment vs Years.

iii) Production vs Years

iv) Capex(cost) vs Years

Future Manpower Needs of the UK Oil and Gas Industry Sample Answer

Quantifying the Impact of the Drop in Oil on the Future Manpower Needs of the UK Oil and Gas Industry

CHAPTER 3: METHODOLOGY

  • Introduction

The dramatic and drastic decline in the oil and gas prices in the UK over the years has significantly impacted on the future workforce needs of the country’s gas and oil industry.

Future Manpower Needs of the UK Oil and Gas Industry
Future Manpower Needs of the UK Oil and Gas Industry

The instability of oil and gas production which has been orchestrated by the declining prices has heightened this devastating effect on the future workforce needs in the UK’s oil and gas industry. This is attributed to the fact that, the consistent decline in oil and gas prices has created an unsuitable environment for the oil and gas industry to continue its growth through production expansion, and this has subsequently led to a negative impact on the future workforce drivers and needs. As a result, quantifying the impacts of this decline in gas and oil prices on the future workforce needs of the UK is imperative in order to enable formulation and implementation of corrective as well as mitigation measures for  minimizing or effective management of these effects of declining oil and gas prices (Dixon & Rimmer, 2012).

Therefore, the research design and methods adopted in study strive to ensure that the objectives of the study are achieved. Thus, using the appropriate research methodology will enable the five research objectives of this project to be achieved based on the quantitative data collected about the stipulated research variables both independent and dependent. The specific research objectives of this study are as follows: 1) To demonstrate how the dramatic and unexpected drop in gas and oil prices affected the UK upstream oil and gas workforce; 2) To describe the types of skills profiles and demand in the upstream oil and gas workforce; 3) To evaluate the skills set of those have been most impacted; 4) To demonstrate the future Manpower needs of UK upstream workforce by using statistical graph based on probability of production, and 5) To discuss or analyze the effective responsibility of UK’s oil and gas industry human resources towards employment.

As a result, the aim of this study is to quantify the impacts of the dramatic drop in prices of oil and gas on the future workforce needs of the United Kingdom Oil and Gas Industry. The study will use the dynamic Computable General Equilibrium (CGE) model in order to effectively quantify the impacts of dramatic fall in oil and gas prices on the future workforce needs of the UK Oil and Gas Industry as an appropriate research strategy to ensure that the research objectives are achieved. This research method has used oil and gas price scenarios to enable measurement of the trends of declining oil and gas prices impacts on the future workforce needs in the UK relative to the baseline.

  • Research Philosophy and Design

Research philosophy and design have been widely applied in studies as a guide to achieving the research objectives. Saunders, Lewis, and Thornhill (2009) noted that mainstream researchers had been commonly applying two main research philosophies such as positivist and interpretive. According to Lewis and Thornhill (2009), the wide application of these two research philosophies has been attributed to their significance in guiding the research studies as well as the nobility of research in demanding researchers to adopt them and ensure that they are in conformity with the objectives of the study.

In this research study, positivist research philosophy has been applied in order to quantify the impacts of the dramatic drop in prices of oil and gas on the future workforce needs of the United Kingdom Oil and Gas Industry based on the dynamic Computable General Equilibrium (CGE) model. Hill (2003) noted that the reason why positivist philosophy is commonly used because of its recognition and adherence to the norms and rules in the business environment. As a result, for the application of positivist research approach, a researcher is required to rely on the businesses’ background environments and use the appropriate scientific methods to enable the determination about the nature of such business scenarios subsequent to their quantification. This is the reason that justifies why this choice of research approach was selected in this study.

In addition, the study also a quantitative research because the variables were chosen for quantification such as oil prices, the number of employment (indirect, direct and induced), production levels as well as capital investment in oil and gas production requires a collection of quantitative data. This is mainly because the study particularly involves quantification of the impacts on the future of workforce needs in the UK’s oil and gas industry if crude oil prices continue to drop or there is a change in this trend and crude oil prices begin to rise. This means that the research is a projection study. Furthermore, based on the outcomes or findings obtained from the quantification of the impacts of the drop in oil prices on the future workforce needs in the UK’s oil and gas industry, the researcher attempts to devise the appropriate course of action for the oil and gas industry to implement in achieve sustainability in relation to Manpower.

  • Research questions

The research will focus on answering the following questions, by which they will act as the blueprint of all the analysis:

  • Has the number of employees differ significantly?
  • Is there a significant decrease in the price of oil in the United Kingdom?
  • How does the dramatic and unexpected drop in gas and oil prices affect the UK upstream oil and gas workforce?
  • What type of skills profiles and demand in the upstream oil and gas workforce?
  • Which skills set have been most impacted mostly?
  • What is the future manpower needs of UK upstream workforce by using statistical graph based on the probability of production?
  • What effective responsibility of UK’s oil and gas industry human resources do towards employment?
    • Research Model

The Dynamic Computable General Equilibrium (DCGE) model used in this study adopted various variables both independent and dependent in order to make sure that the research objectives were achieved (Cardenete, Guerra & Sancho, 2012). In this case, the independent variable Brent’s crude oil prices in dollars while dependent variables were the number of employment (indirect, direct and induced), production levels as well as capital investment in oil and gas production. A DCGE Model is without any doubt one of the quantitative research methods that are most rigorous and cutting-edge in evaluating the impacts of policy and economic shocks, particularly price shocks as well as policy reforms in the economy, whether in entirety or one sector. Because of this nature of DCEG Model, this tool is of significant use for the quantification of the impacts of a drop in oil and gas prices on the future Manpower needs in the UK’s oil and gas industry (Mitra-Kahn, 2008).

Thus, through DCEG modeling the most possible realistic status of the economic impacts to be quantified can be reproduced, particularly by simulating the structure of the economy, whether in entirety or one sector. Therefore, this is imperative in quantifying the nature and status of all economic transactions done by various economic agents, including households, productive sectors, and the government, among others (Piermartini & The, 2005). Furthermore, data analysis based on DCEG Research Model compared to other available tools or technique is able to capture a broader range of economic impacts already derived or anticipated from a global price shock or formulation and implementation of a particular policy reform, specifically on the employment dynamics, in particular, the future workforce needs to be considered for this study (Mitra-Kahn, 2008). In that sense, it is useful to adopt the DCEG research model approach, especially when the anticipated impacts of global price shock are complicated, and their materialization occurs through a variety of transmission channels.

To achieve the objectives of the study, a DCEG model was used to assess the impacts anticipated from future changes on the prices of oil on the economy of UK, particularly in the context of three alternative scenarios. The model is used to quantify the estimates of how the UK economy will possibly react to changes in prices, technology, the policy as well as other external factors by focusing on the envisaged interactions between varied industrial sectors, the government, households and the rest of the world (Piermartini & The, 2005). The justification for using this model is informed by the fact that, these models have been considered as the standard tool in conducting economic analysis empirically, and have enjoyed wide recognition and utilization by international financial organisations such as the OECD, the World Bank and the IMF as well as central banks, national governments and the European Commission (Piermartini & The, 2005; Mitra-Kahn, 2008).

The simulation was done by reducing prices of output in the economic sector of oil and gas extraction industry and the prices of inputs from other economic sectors, which is done carefully by taking into account the different sectors’ relative oil intensity and the assessment during the period to 2020 were done. Different case study scenarios of an oil price shock have been simulated of the UK economy based on DCEG model to quantify the impacts of the dramatic drop in prices of oil and gas on the future workforce needs of the United Kingdom Oil and Gas Industry. A three projected oil and gas price scenario based on a disparity both magnitude and persistence of oil, and gas price’s shock against 2016 baseline have dominantly been used for research studies. However, three projected oil and gas price scenario has been structured to provide the statistical analysis of the future oil and gas price’s trends and the United Kingdom trade position in oil and gas industry to provide generate study reliable and valid research findings and the results.  Scenario 1: Oil and gas price set at a low level ($50/barrel), Scenario 2: Oil and gas price in 2020 increases gradually to $73/barrel. Scenario 3: Gas and oil price in 2020 gradually to$108/barrel. The baseline is assumed to be inconsistency with the projected workforce growth for the gas and oil industry in the UK published in July 2015.

This study has applied the available statistical analysis tools in order to carry out the analysis of the collected data to obtain results of the entire study. As such, quantitative data on the research variables will be collected and analyzed while taking note on the positivist approach in this study in addition to anchoring it through the review of existing literature studies. Thus, the researcher will gather relevant information concerning the included variables in order to ensure that the research objectives are achieved. Therefore, the data analysis in the study is mainly done based on Microsoft Excel as well as the Statistical Packages for Social Sciences (SPSS). This means that, the Dynamic Computable General Equilibrium (DCGE) model is an imperative research tool that serves as a guiding tool in addressing the study objectives through assessment of the impacts of declining oil and gas prices on the future workforce needs in the UK’s oil and gas industry (Dixon & Jorgenson, 2013).

Future Manpower Needs of the UK Oil and Gas Industry Data Analysis and Findings

The analysis of data collected from 2010 to 2016 on variables such as Brent’s crude oil price in dollars, total employment levels (direct, indirect and induced), crude oil production per year in thousand barrels and capital investment per year in billion ₤ has been present in the tables shown below ranging from Table 1 to Table 4.

Table 1: Employment- Headcount
Year 2010 2011 2012 2013 2014 2015 2016
Direct 32,000 32,000 35,840 36,600 41,700 38,200 34,000
Indirect 307,000 307,000 300,000 198,100 201,000 160,600 151,500
Induced 101,000 100,000 112,000 206,200 211,100 170,800 144,900
Total Employment
440,000 439,000 447,840 440,900 453,800 369,400 330,400
Table 2: Employment and Brent Crude Oil Price ($) .
Year 2010 2011 2012 2013 2014 2015 2016
Direct 32,000 32,000 35,840 36,600 41,700 38,200 34,000
Indirect 307,000 307,000 300,000 198,100 201,000 160,600 151,500
Induced 101,000 100,000 112,000 206,200 211,100 170,800 144,900
Price 79.61 111.26 111.63 108.56 98.97 52.32 46.64
Table 3: Production of Crude oil (Thousand barrels) per Year
Year 2010 2011 2012 2013 2014 2015 2016
Production 62,962 51,972 44,561 41,101 40,328 45,698  
 

Table 4: Capital Investment (Billion £) vs. Year
Year Cost (Billion £)
2010 10.7
2011 19.2
2012 11.4
2013 14.4
2014 14.8
2015 9.0
2016 10.1

To answer the first research question, a chi-square test was performed to determine whether there was a significant change in the number of employees. The results are:

Table 5: Chi-square test

Data
Level of Significance 0.05
Number of Rows 3
Number of Columns 7
Degrees of Freedom 12
Results
Critical Value 21.02607
Chi-Square Test Statistic 184145.2
p-Value 0
Reject the null hypothesis
Expected frequency assumption
       is met.

The results suggest that the distribution of the number of employees is not the same. Therefore, we can state that there was a decline in the number of employees with time, which is illustrated by a bar plot below.

Figure 1: Employment headcount versus Year

The Linear 0, shows a decreasing trend in the total employment.

For the second research question, the regression test was carried out and the results were as follows.

Simple Linear Regression Analysis
Regression Statistics
Multiple R 0.6332
R Square 0.4009
Adjusted R Square 0.2811
Standard Error 23.7035
Observations 7
ANOVA
  df SS MS F Significance F
Regression 1 1880.2608 1880.2608 3.3465 0.1269
Residual 5 2809.2823 561.8565
Total 6 4689.5431
  Coefficients Standard Error t Stat P-value Lower 95% Upper 95%
Intercept 16582.8146 9017.3237 1.8390 0.1253 -6596.9539 39762.5832
Year -8.1946 4.4795 -1.8293 0.1269 -19.7097 3.3204

The significance F value suggests that there is no significant association between the price of the crude oil and the year. This is because the p-value is greater than the level of significant .05. This means that although there was a decline it was not attributed to time.

Additionally, a DCEG approach analysis based on a UK economy’s model for the quantification of the impacts envisaged to possibly arise from the declining prices of oil in three alternative scenarios both in permanent and temporary reduction show varied results. For instance, a permanent reduction in oil prices, the price of around $50 per barrel was settled at and the UK economy in terms of GDP increased by approximately 1% on average relative to between 2015 and 2020 baseline. The same report indicated that by 2020 employment levels would increase by around 90,000, while a peak boost to levels of employment would be realized in 2016 by around 120,000. In contrast, smaller impacts are observed where there is a temporary decline in the prices of oil and gas: depending on how fast and far oil and gas prices rebound, there could be variations in the boost to GDP from 0.25 to 0.5% and the increase in employment levels by 2020 could also vary between 3,000 and 37,000.

Future Manpower Needs of the UK Oil and Gas Industry Discussion

Although, there is an envisaged negative impact on the future workforce needs in the UK’s oil and gas extraction industry because of the declining prices of oil and gas, other sectors such as transportation, oil-intensive manufacturing, agriculture, and refined petroleum manufacturing sectors are expected to significantly benefit from these scenarios of the decrease in the prices of their key inputs. This would play a fundamental role in boosting both capital investment and job creation in these sectors, and the oil and gas industry can considerably improve their revenues by expanding their downward operations by widening their collaborations within the supply chain and service delivery. As a result, the human resources in the oil and gas industry in the UK have a responsibility towards employment, including the to hire people who possess the right or appropriate qualifications and skills on the job, which would subsequently lead to improved performance as well as the creation of more employment opportunities. Moreover, the goals and objectives of companies in the UK’s oil and gas industry should be aligned towards creation of more jobs by ensuring that they achieve improved employee performance, which is attainable by embarking on carrying out regular employee performance evaluations, as well as organizing routine career training and professional development programs (Hsin-His, 2012).  Furthermore, human resources can also fulfill their responsibility on employment through appropriate changes in companies’ organizational cultures, style of leadership, workplace environment, motivation, organization structure, as well as job satisfaction among others (Al Muftah & Lafi, 2011).

4.1.Conclusion and recommendation

The research has pointed out that there is a change in the number of employees in the oil and gas industry in the UK. In fact, this has a detrimental effect on the economy as well as the social life of the citizens. The results support that there has been a decline in the number of employees in this sector which requires UK government intervention to improve the condition as well as create more jobs. As earlier stated to improve this condition some adjustments need to be made like, employing highly qualified personnel, carrying performance evaluation more often, as well as ensuring that the human resource in this sector executes their mandates as required. Although, it was established that the price of the crude oil and the variable year, it is imperative for the prices of the UK oil and gas to be considerably low to benefit other sectors. This is because, if the oil and gasses’ prices are set at minimal, the cost of production, transportation, agriculture among others will intensely benefit. Thus, it is within the UK’s government mandate to ensure that the petroleum prices are consistently low to boost oil dependent sectors, which improves the revenue generation, production and service’s delivery. To make this a reality, the UK government will continue subsidizing the fossil fuel. Through this, the government will ensure that they reap maximum returns from this sector, such as job creation, improved service delivery, generation of revenue among others. The dynamic Computable General Equilibrium pointed out that when the oil and gasses’ prices are low, there are increases in the UK GDP. Therefore, there is a great urge to keep the prices of the oil and gasses low to boost the GDP of the country. Therefore, the government should set up strategies that ensure that the oil and gasses are low, like eliminating intermediaries in the supply chain, subsidizing the oil and gasses sector, or not taxing these products.

The research was successful since the objectives of the research have been achieved. Given another chance in the future, I would make some adjustment on the research. For instance, an increase in the sample size of the data to increase accuracy. This can be achieved by using monthly data instead of annual data. Also, since literature shows that from 2010 to mid-2014 the prices were steady and after that the prices declined. A test of whether the two-period prices are significantly different would be carried out. This will help in testing whether the claim that there is a recent decline in the oil and gasses’ prices.

Future Manpower Needs of the UK Oil and Gas Industry References

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Bogdan, R. C. & Biklen, S. K. (2012), Qualitative research for education: An introduction to theory and methods. Boston, MA: Allyn & Bacon Publishing.

Cameron, R. (2011), “Mixed Methods Research: The Five Ps Framework”, Academic Publishing International Ltd, Vol. 9 Issue 2, pp. 96-108.

Cardenete, M. A., Guerra, A-I., & Sancho, F. (2012), Applied General Equilibrium: An Introduction. New York, NY: Springer Publishing Company.

Creswell, J. W. (2007), Qualitative inquiry and research design: Choosing among five traditions, (2nd edition). Thousand Oaks, CA: Sage Publications.

Denzin, N. K. & Lincoln, Y. S. (2011), Collecting and interpreting qualitative materials, (4th edition). Thousand Oaks, CA: Sage Publications.

Dixon, P. & Jorgenson, D. W. ed. (2013), Handbook of Computable General Equilibrium Modelling, Vols. 1A and 1B. North Holland: Elsevier Publications.

Dixon, P. & Rimmer, M. (2012), Dynamic General Equilibrium Modelling for Forecasting and Policy: A Practical Guide and Documentation of MONASH. North Holland: Elsevier Publications.

Driscoll, D. L., Appiah-Yeboah, A., Salib, P., & Rupert, D. J. (2007), “Merging Qualitative and Quantitative Data in Mixed Methods Research: How To and Why Not”, Ecological and Environmental Anthropology, Vol. 3 Issue 1, pp. 19-28.

Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2010), Multivariate data analysis: A global Perspective, (7th edition). Hoboken, NJ: John Wiley and Sons.

Marshall, C. & Rossman, G. B. (2011), Designing qualitative research, (5th edition). Thousand Oaks, CA: Sage Publications.

Maxwell, J. A. (2005), Qualitative research design: An interactive approach, (2nd edition). Thousand Oaks, CA: Sage Publications.

Merriam, S. B. (2009), Qualitative research: A guide to design and implementation. San Francisco, CA: Jossey-Bass Publications.

Mertler, C. A. & Charles, C. M. (2011), Introduction to educational research, (7th edition). San Diego: Pearson Education.

Mitra-Kahn, B. H. (2008), Debunking the Myths of Computable General Equilibrium Models, SCEPA Working Paper No. 01-2008, World Trade Organization, Geneva.

Onwuegbuzie, A. J. & Collins, K. (2007), “A Typology of Mixed Methods Sampling Designs in Social Science Research”, The Qualitative Report, Vol. 12 Issue 2, pp. 281-316.

Piermartini, R. & The, R. (2005), Demystifying Modelling Methods for Trade Policy, Discussion Paper No. 10, World Trade Organization, Geneva.

Rajasekar, S., Philominathan, P., & Chinnathambi, V. (2013), Research Methodology. Available at: http://arxiv.org/abs/physics/0601009v3 [Accessed on 2nd January 2017].

Saunders, M., Lewis, P., & Thornhill, A. (2009), Research methods for business students. Harlow, England: Prentice Hall.

Schram, T. H. (2013), Conceptualizing qualitative inquiry. Columbus, OH: Merrill Prentice Hall Publishing Company.

Taylor, G. (2005), Integrating Quantitative and Qualitative Methods in Research. New York, NY: University Press of America.

Personal Development Portfolio Research Study

Personal Development Portfolio Research Study Order Instructions: How has your understanding of your research study changed since this module started? This week, you will reflect on the basic research principles and knowledge that you have acquired in this module.

This final PDP Assignment aims to build on the knowledge from the module and apply this to the real world.

Personal Development Portfolio Research Study
Personal Development Portfolio Research Study

This Research Methods module has provided you with an understanding of the principles and skills needed in order to design and conduct business management research. This week’s Personal Development Portfolio activity will enable you to reflect on your learning and experiences. You will consider how these concepts will apply to the next step, whether this is relating to an academic research project or any other research that you may undertake for the investigation of a business problem in your professional context.

To prepare for this PDP Assignment:

• How has the information that you have discussed across the entire class, researched and read helped you to understand the practice of academic research and the type of research skills that you have developed over your previous modules?

• Have your ideas and views of academic research now changed?

• How has your understanding of academic research and your own ability to conduct research developed?

• How will you apply what you have learnt so far and overall when conducting future research?

• What is the importance of ethical conduct in research, and how might this influence any potential, future research projects that you undertake?

 

Personal Development Portfolio Research Study Sample Answer

Personal Development Portfolio

Introduction

The fundamental role of this paper is to mainly reflect on the study which I came upon in the four weeks period of the module. First of all, I would like to establish the way in which the processed data explained in the lecture theater, read and researched has helped me towards the comprehension of the activities of the academic study and the structure of the studying techniques which I have to build up in the past units. The second goal is the way that my concepts and point of views regarding the academic study have drastically changed. Thirdly, will look deeply how my comprehension of the academic research and personal potential to perform an inquiry has grown. Lastly, will try to disclose to the readers how I will personally employ what I have acquired as far as academic research is concerned.  The knowledge gained will assist me to undertake future studies.

Learning points

The processed data explained in the lecture class, read and researched has permitted me to possess an excellent comprehension of the academic research activities. For example, I considered that the study topic that’s look to be examined is mandated to be directive and precise. That is, it portrays to the readers the actual meaning of the research and the possible connection among the variables, (Bell, 2014). When conducting a research study, it is the focus of an inquirer to offer future studies instruction on the research issues under the research questions.

The fundamental nature is not only aimed to create the know-how built but also attempt and answer any queries which have been left undisclosed. Additionally, I have learned that the capability of a person conducting the research to come up with fields that require additional studies shows that an examiner is not only enthusiastic but also on the set to hold up the continuation of the research, (Sarantakos, 2012).

The facts about the research methodologies and design also assisted me to comprehend that the study procedure is a methodical process. That is, it needs an individual to come up with the study topic, narrate the motive for the concentration in the area under discussion, shed light on the goal to instruct the research system, and work out the research queries, (Sutirtha, Moddy, Lowry, Chakraborty, Hardin, 2015). Above and beyond the research activities demands an individual to investigate the past research which has been conducted out on the same research topic and develop broad-ranging research methods to grow the vital data for analysis. The studying process includes the findings reporting, providing the recommendation, and coming up with opportunities for long-term studies. Despite the fact that each and every segment of the studying system is important, emphasis should focus on the methods used to conduct the research. The reality of the matter is that the environment of the techniques used has the propensity to establish how relevant the results will be displayed out. The focused part should be on the research paradigm, (Glogowska, 2015). That is the investigator has to be very cautious when it comes to the selection of the proper research methods to carry out the research.

My concepts and point of views as far as the academic study is concerned are that they have drastically changed. It is because; in the past, my perception about the research system was purely meant to satisfy the board of examiners so that I could excellently prosper in my exams. All I thought of was to be successful as far as higher education program is concerned. On the contrary, I am fully conscious that the academic studies progression may have a bigger impact on the community as a whole, (Collis, and Hussey, 2013). That is, it might help in coming up with appropriate solutions to solve challenges that have prolonged to confront the community. As a matter of fact, it is fundamental to take on the academic studies with caution and bring together the endeavor in easing the stipulated measures.

Personal Development Portfolio Research Study and the Development points

I believe that I require studying more about the submission of the mixed methods in the research design. That is the qualitative and qualitative research methods used in the survey. As the unit is leaning me as the researcher towards these techniques, I am not in a position to comprehend how the two methods can be employed simultaneously. Personally, I embrace that throughout the employment of the mixed methods of the research design that the investigator or the researcher uses, can be permitted to show full-bodied and more having substantial effects on findings, (Bazeley, and Kemp, 2012). Therefore, as an individual, I think that I should personally make concentrated efforts to fully comprehend the claims of the mixed methods of the research design (qualitative research methodology and quantitative research methodology), (Bryman, and Bell, 2015)

Also, I will make sure that I take into consideration ethical issues related to the academic research. That is, before undertaking any study will be vital to seek permission, communicate to the respondent in writing, and plan on how to store data. Following this ethical issue, as the researcher, I will be morally right or ethical to conduct the research.

Conclusion

Conclusively, my comprehension about the academic studies and my capacity to perform an academic research has grown enormously. As a person, I am not quite sure about the multiple methods contained and how to relate to them efficiently and effectively. For instance, I currently have the know-how of where an individual can draw from the issues of the study. That is, the accessible societal position quo, and the prevailing prose can assist an individual to pin down a problem that needs the examination to establish an appropriate cause of the research. In the long run, as a researcher, I will employ the knowledge I have acquired as far as academic research is concerned to help me conduct definitive studies in an effective and efficient way. For instance, instead of looking for broad objectives and topics, with the knowledge I have about the academic research I believe I will be on point and precise. It will permit me to focus on my future investigation. What’s more, as a researcher is that I will look for multiple approaches in the course of my research that will make sure that my research proposal is reliable and credible, free from any biases, (Grant, 2016). In this kind of manner, as a researcher I will be a responsible for the basis of the know-how despite the consequences of how complicated a challenge may seem to be.

Personal Development Portfolio Research Study Bibliography

Bazeley, P. and Kemp, L., 2012. Mosaics, triangles, and DNA metaphors for integrated analysis in mixed methods research. Journal of Mixed Methods Research, 6(1), pp.55-72.

Bell, J., 2014. Doing Your Research Project: A guide for first-time researchers. McGraw-Hill Education (UK).

Bryman, A. and Bell, E., 2015. Business research methods. Oxford University Press, USA.

Collis, J. and Hussey, R., 2013. Business research: A practical guide for undergraduate and postgraduate students. Palgrave macmillan.

Collis, J. and Hussey, R., 2013. Business research: A practical guide for undergraduate and postgraduate students. Palgrave macmillan.

Glogowska, M., 2015. Paradigms, pragmatism and possibilities: mixed-methods research in speech and language therapy. International Journal of Language & Communication Disorders, pp.1-10.

Grant, R.M., 2016. Contemporary strategy analysis: Text and cases edition. John Wiley & Sons.

Sarantakos, S., 2012. Social research. Palgrave Macmillan.

Schreier, M., 2012. Qualitative content analysis in practice. Sage Publications.

Sutirtha, C., Moddy, G., Lowry, P.B., Chakraborty, S.,& Hardin, A. (2015), “Strategic Relevance ofOrganizational Virtues Enabled by Information Technology in Organizational Innovation,” Journal of Management Information Systems, Vol. 32,No. 3, pp. 158-196.

 

 

Mixed Methods of Research Design

Mixed Methods of Research Design Order Instructions: Mixed methods research provides a new way for some researchers to tackle a complicated research problem.

Mixed Methods of Research Design
Mixed Methods of Research Design

The key purpose is to investigate the problem by using the advantages of both quantitative and qualitative methods to enrich the approach. However, at the same time, it requires knowledge of both methods of data collection and analysis and a good reason for the choices made. For this week’s Key Concept Exercise, you will consider whether a mixed method would fit (or not) your research topic-problem and the anticipated barriers to data integration.

To prepare for this Key Concept Exercise:

•Read the Required Learning Resources.

•Return to your chosen research topic-problem identified in Week 1 (as subsequently amended) and consider whether a mixed methods approach would be appropriate and why

•In approximately 550 words, explain why mixed methods might fit (or not) your research project.

•In formulating your Key Concept Exercise, consider the following questions:

o What are the strengths and weaknesses of your chosen method?

o Critically analyse the reasons why you would proceed (or not) with the adoption of mixed methods

o What are the barriers to data integration which you would expect at this stage of the research?

o What are the potential limitations and problems associated with adopting a mixed methods approach for a relatively short research project – for example, a dissertation of 9 months’ duration?

My Research topic:

Aim: To identify and explore the human resource strategies that influence employee engagement within organisations in Qatar and to develop recommendations on how these human resource strategies can be changed in order to improve employee engagement.

Research Questions:

RQ 1: Which human resource strategies influence employee engagement within organisations in Qatar?

RQ 2: How do these human resource strategies influence employee engagement within organisations in Qatar?

RQ 3: How can these human resource strategies be changed in order to improve employee engagement within organisations in Qatar?

End Product:Objective: To develop recommendations on how human resource strategies can be changed in order to improve employee engagement within organisations in Qatar.

Mixed Methods of Research Design Sample Answer

Mixed Methods of Research Design

Mixed methods in the background of the research design have been defined as the methodology that entails theoretical assumptions which instruct the direction of gathering and analyzing data and the mixture of quantitative and qualitative information in a single research or series of research, (Creswell, 2014). Using both the quantitative and qualitative methods offers a unique comprehension of the research question (To identify and explore the human resource strategies that influence employee engagement within organizations in Qatar and to develop recommendations on how these human resource policies can be changed to improve employee engagement)

Reasons for the adoption of the mixed methods

There exist various reasons as to why the mixed methods have been regarded to be of the greatest significance. Some of the reasons are; expansion, initiation, development, complementarily, and triangulation.

Initiation

Bazeley and Kemp (2012) suggest that the results from one of the two methods may come up with a new set of issues which requires being further explained. It means that it initiates another study with various sources of data.

Expansion

The research of the survey tends to develop one research by using results or finding from the other, (Fetters, Curry, and Creswell, 2013). That is the researcher may use qualitative findings to comprehensively conclude on the study done by use of quantitative methods and vice versa.

Complementarily

The researcher does complement the conclusions from a given source by using various sources of data, (Bazeley, and Kemp, 2012)

Triangulations

Using multiple sources of data to search for the validation of every finding of either qualitative or quantitative methodologies, (Fielding, 2012)

Barrier of the mixed methods

Various restrictions are expected when integrating the two approaches. Some of the obstacles are discussed as follows;

The publication issues

It is suggested that the problem of writing might block integration. That is the propensity of some of the secondary sources to stress on either the qualitative or quantitative study might slow down integration since they have the tendency to require either of the qualitative or quantitative proof to be highlighted, (Venkatesh, Brown, and Bala, 2013)

Strength and weakness

Mixed methods of research designs have both weaknesses and strengths, (Creswell, 2013). Both will be discussed in general as follows

Strengths

  1. It offers a broader perspective. That is, when using a single methodology, the researcher can only be able to establish the cause and effect of a particular problem. However, when integrating the two together, it becomes possible to look into the study broadly.
  2. More data brings the expansion of the study in a manner that a single methodology cannot. By using the mixed methods, the researcher is assured of overall findings.

Weaknesses

  1. Researchers are different and when it comes to choosing the methodologies; they become bias. That is they tend to give more weight on a given method over the other method, (Sarantakos, 2012)

2.There exist the problem of exploration and analysis.

Potential limitation

The potential barrier of a mixed method of research design is ethical challenges. Since the study only takes at least nine months and the researchers are required to use both approaches, he or she may not pay key attention to the ethical issues that relate to the study, (Ritchie, Lewis, Nicholls, and Ormston, 2013).  For example, the researcher can omit the issue of confidentiality. He or she may disclose a source from the qualitative study without his/her knowledge or at times may not consider that issue of requesting permission before commencing on an interview or taking pictures. It becomes an ethical problem to the researcher.

Mixed Methods of Research Design Bibliography

Bazeley, P. and Kemp, L., 2012. Mosaics, triangles, and DNA metaphors for integrated analysis in mixed methods research. Journal of Mixed Methods Research, 6(1), pp.55-72.

Creswell, J.W., 2013. Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.

Creswell, J.W., 2014. A concise introduction to mixed methods research. Sage Publications.

Fetters, M.D., Curry, L.A. and Creswell, J.W., 2013. Achieving integration in mixed methods designs—principles and practices. Health services research, 48(6pt2), pp.2134-2156.

Fielding, N.G., 2012. Triangulation and mixed methods designs data integration with new research technologies. Journal of Mixed Methods Research, 6(2), pp.124-136.

Ritchie, J., Lewis, J., Nicholls, C.M. and Ormston, R. eds., 2013. Qualitative research practice: A guide for social science students and researchers. Sage.

Sarantakos, S., 2012. Social research. Palgrave Macmillan.

Venkatesh, V., Brown, S.A. and Bala, H., 2013. Bridging the qualitative-quantitative divide: Guidelines for conducting mixed methods research in information systems. MIS quarterly, 37(1), pp.21-54.

 

Review of Qualitative Research Design

Review of Qualitative Research Design Order Instructions: Review of qualitative research design
While neither quantitative nor qualitative approaches can be considered complete without bias, qualitative methodologies and methods are, by far, the more subjective of the two.

Review of Qualitative Research Design
Review of Qualitative Research Design

In all research, the presence of the researcher, their choices and their interpretations, have a bearing on the work undertaken and data collection methods are chosen. Qualitative researchers have a greater level of involvement drawing on their own backgrounds, experiences and perceptions in their interpretation of the data collected. Qualitative research, therefore, has a degree of ‘built-in’ bias which should be acknowledged in a research study.

Read the Required Learning Resources for Review of Qualitative Research Design

Return to your qualitative research designs from last week

Critically reflect on the types of qualitative data collection methods that you could use in your research, considering their benefits and limitations. Consider how you might overcome the challenges that you may encounter when implementing research using the qualitative methodology, including the management and analysis of data.

My research:

Interpretive Research

Aim: To identify and explore the human resource strategies that influence employee engagement within organizations in Qatar and to develop recommendations on how these human resource strategies can be changed in order to improve employee engagement.

Review of Qualitative Research Design and Research Questions

RQ 1: Which human resource strategies influence employee engagement within organizations in Qatar?

RQ 2: How do these human resource strategies influence employee engagement within organizations in Qatar?

RQ 3: How can these human resource strategies be changed in order to improve employee engagement within organizations in Qatar?

End Product:Objective: To develop recommendations on how human resource strategies can be changed in order to improve employee engagement within organizations in Qatar.

Review of Qualitative Research Design Sample Answer

 

Review of Qualitative Research Design

Introduction

This project will focus on identifying and exploring the human resource strategies that influence employee engagement within organizations in Qatar. In addition, the project will develop recommendations on how these human resource strategies can be changed in order to improve employee engagement. The project will embrace qualitative techniques due to their uniqueness and depend on texts as well as image information (Creswell, 2014). Besides, the qualitative methodology can present flexibility based on its structure that is largely anchored on the interpretive approach (Collis & Hussey, 2013). In other words, findings strongly reflect the subject being explored. In general, qualitative methodology is a collection of interpretive methods that not only seek to describe but also decode, translate and find the meaning of natural occurrences. (Van Maanen (1979). Therefore, the objectives of this study will be guided by a number of research questions.

Research Questions

  1. Which human resource strategies influence employee engagement within organizations in Qatar?
  2. How do these human resource strategies influence employee engagement within organizations in Qatar?
  3. How can these human resource strategies be changed in order to improve employee engagement within organizations in Qatar?

Objective

To develop recommendations on how human resource strategies can be changed in order to improve employee engagement within oorganizationsin Qatar.

Qualitative Research Methods

This study will use focus group discussion and structured interviews. Structured interviews are appropriate for this study because questions are standardized, hence participants views can be compared while allowing the researcher to observe trends. In addition, structured interviews can provide detailed views about the human resource strategies that influence employee engagement within organisations in Qatar (Cassell et al., 2009). However, the personality of the interviewer can affect the responses making the results unreliable.                                     On the other hand, focus group discussions will be important in collecting detailed information on human resource strategies. Compared to interviews, focus group discussions are cheap and time efficient. Nevertheless, focus groups can be complex to analyse. Again, they can lead to disagreements and irrelevant views, thus distract the major objective of a research project.

Review of Qualitative Research Design Analysis Strategy

In a qualitative study, the main analytical strategies include computer software such as SPSS and Excel, data reduction, data representation and arriving at conclusions based on the data (Collis & Hussey, 2013). For this project, the appropriate analysis strategy is the use of computer software to code and reduce data while eliminating engaging tasks related to data collection (Collis & Hussey, 2013). In qualitative research, this strategy is useful when it comes to organising and managing the collected information and representing patterns within the information. However, a researcher should learn how to use this strategy before trying to implement it.

Validity Strategies

Validity refers to the degree by which sound measures help the researcher draw the conclusion. In qualitative research, validity is an important component because of its major strength in evaluating the accuracy of the findings from the researcher’s standpoint (Creswell, 2014). Various strategies will be used to determine the validity of the study. This will include the use of interviews and focus group discussions on measuring human resource strategies that influence employee engagement in various organisations in Qatar.

Review of Qualitative Research Design Conclusions

Qualitative research that is anchored on structured interviews is essential when it comes to interrogating a certain issue. In this case, the study set out to investigate the significance of human resource strategies in altering employee engagement within an organisation. This is largely because with the qualitative approach the researcher will be able to decode, translate and establish the essence of natural occurrences. However, certain factors may impact the outcome of any study.

Review of Qualitative Research Design References

Bryman, A. and Bell, E., 2015. Business research methods. Oxford University Press, USA.

Buchanan, D.A. and Bryman, A., 2007. Contextualizing methods choice in organizational                        research. Organizational Research Methods, 10(3), pp.483-501.

Cassell, C., Bishop, V., Symon, G., Johnson, P. and Buehring, A., 2009. Learning to be a qualitative management researcher. Management Learning, 40(5), pp.513-533.

Collis, J. and Hussey, R., 2013. Business research: A practical guide for undergraduate and          postgraduate students. Palgrave Macmillan.

Creswell, J.W., 2013. Research design: Qualitative, quantitative, and mixed methods approach.                 Sage publications.

Saunders, M., Lewis, P and Thornhill, A. 2012. Research Methods for Business Students, 6th ed.   Pearson Learning Solutions.

Van Maanen, J. (1979) ‘Reclaiming Qualitative Methods for Organizational Research: A                           Preface’. Administrative Science Quarterly, 24(4), pp.520-26.

Research Ideas for a Qualitative Research Project

Research Ideas for a Qualitative Research Project Order Instructions: •Read the required Learning Resources.

Research Ideas for a Qualitative Research Project
Research Ideas for a Qualitative Research Project

• Return to your chosen research topic-problem identified in Week 1 (as subsequently amended) and consider a qualitative approach

• In approximately 550 words, explain how your research ideas could take the shape of a qualitative research project.

•Which qualitative methodology would be most suited to your research paradigm?

•In what way could you contextualize your research from a qualitative perspective?

• Which sampling methods would be most valuable for your data collection?

• What are the key differences in planning your research from a quantitative and qualitative perspective?

Interpretivist Research

Aim:To identify and explore the human resource strategies that influence employee engagement within organizations in Qatar and to develop recommendations on how these human resource strategies can be changed in order to improve employee engagement.

Research Ideas for a Qualitative Research Project Research Questions

RQ 1: Which human resource strategies influence employee engagement within organizations in Qatar?

RQ 2: How do these human resource strategies influence employee engagement within organizations in Qatar?

RQ 3: How can these human resource strategies be changed in order to improve employee engagement within organizations in Qatar?

End Product:
Objective: To develop recommendations on how human resource strategies can be changed in order to improve employee engagement within organizations in Qatar.

Research Ideas for a Qualitative Research Project Sample Answer

RM KCE W6

How research ideas could take the shape of a qualitative research project.

Research ideas can take shape in the qualitative study through development good research questions. With good research questions, it becomes easier to not only shape but also give a qualitative research direction in ways that are mostly overlooked (Buchanan & Bryman 2007). Effective research questions may not necessarily generate a credible study, however, poorly developed questions will be lead to the challenge in developing sequent phases of the research. In qualitative research, research questions is important for comprehending various perspectives
Appropriate Qualitative Methodology

The research paradigm is the philosophical worldview and understanding that underpins how to perform and analyze a given research project (Cresswell, 2014). After establishing the worldview it is necessary to choose the appropriate qualitative methodology suitable for the research paradigm. Therefore, when it comes to identifying and exploring the human resource strategies that influence employee engagement within organizations in Qatar, grounded theory is appropriate. Grounded theory has widely used the methodology in qualitative research (Bryman & Bell, 2015). In this case, it involves a researcher avoiding confinement within the limitations of the existing theory (Collis & Hussey, 2013).                                                Additionally, a researcher must be objective while allowing data collection procedure to inform fresh theories. With grounded theory, data collection is a continuous procedure of comparing information as it emerges and purposes to provide a broader assessment of phenomena towards data saturation to help in determining dimensions. Much as time constraints and challenges associated with coding may be problematic in small studies, grounded theory has the ability to capture intricacies in organizational scenarios and connect research to practice (Bryman & Bell, 2015).

Way to contextualize the research from a qualitative perspective

In qualitative research it is necessary to relay relevant information to readers, particularly clarifying the objective of the study, the role of the researcher and sampling technique to adopt (Creswell, 2014). Therefore, in this study, I will contextualize my research by putting data into context that entails presenting background data on the human resource strategies that influence employee engagement within organizations in Qatar and further examine my role as a researcher in collecting data as well as analysis.  Data to help contextualize can be related to different elements including legal, economic, time and location (Collis & Hussey, 2013). For the current study, data will be found from published information on organizations in Qatar from different sources to help provide a detailed recognition of qualitative research.

Sampling Methods

 

Cluster Sampling

This sampling technique entails the selection of a certain group within the entire population. The selection largely depends on the accessibility and identifiable characteristics of the group. However, if the population large multiple clustering levels can be employed. For instance, in this research, the focus will be on human resource strategies that influence employee engagement within organizations in Qatar. Therefore, the selection of clusters will be based on the type of organization, human resource strategies, the type of employee and so forth. After establishing clusters, the random sample might be selected from every cluster. Owing to the fact that numbers may be assigned to sampling units, simple random sampling will be suitable (Saunders, Lewis & Thornhill, 2012). After which, these numbers will be randomly selected to form the suitable sample.

A quantitative and qualitative perspective

The main difference between qualitative and quantitative perspective in planning research is that quantitative research is objective while qualitative is subjective (Cassell et al., 2009). An objective study presents results that are based on views; however, they are supported by statistical analysis. The subjectivity of the qualitative perspective is highlighting on theories and feeling hence, it does not allow drawing a definitive conclusion.

Research Ideas for a Qualitative Research Project Bibliography

Bryman, A. and Bell, E., 2015. Business research methods. Oxford University Press, USA.

Buchanan, D.A. and Bryman, A., 2007. Contextualizing methods choice in organizational research. Organizational Research Methods, 10(3), pp.483-501.

Cassell, C., Bishop, V., Symon, G., Johnson, P. and Buehring, A., 2009. Learning to be a qualitative management researcher. Management Learning, 40(5), pp.513-533.

Collis, J. and Hussey, R., 2013. Business research: A practical guide for undergraduate and postgraduate students. Palgrave Macmillan.

Creswell, J.W., 2013. Research design: Qualitative, quantitative, and mixed methods approach.                 Sage publications.

Saunders, M., Lewis, P and Thornhill, A. 2012. Research Methods for Business Students, 6th ed.   Pearson Learning Solutions.

Introduction to the Healthcare Facility

Introduction to the Healthcare Facility
Introduction to the Healthcare Facility

Introduction to the Healthcare Facility

Order Instructions:

The Session Long Project for this course is to evaluate and critique a health care facility you are familiar with and compare it to the general principles and standards for quality assurance presented in this course.

In the earlier modules, you identified a health care facility for the subject of the SLP and presented a description of the facility and its quality assurance program. You also critiqued the facility’s Continuous Quality Improvement program.

In this module, you will discuss and critique the subject facility’s Utilization Management program. The remaining modules for the Session Long Project the remaining tasks are as follows:

SLP Assignment Expectations

For this module, you are to complete the following tasks and to submit a 4- to 5-page paper. (This does not include the title or reference pages):
•Describe and discuss the facility’s Utilization Management program.
•Compare and critique the subject facility’s Utilization Management program to that of a model facility and whether the facility adheres to the recognized standard for utilization management, including utilization review and whether this review leads to improvement in the quality of care.
•Identify areas for improvement in the facility’s Utilization management program, if any, and any recommendations you think should be implemented to improve the quality of patient care.

Module Overview

Utilization Review (UR): A system designed to monitor the use of, or evaluate the medical appropriateness, efficacy or efficiency of health care services, procedures, providers or facilities. utilization review may include ambulatory review, case management, certification, concurrent review, discharge planning, prospective review, retrospective review or second opinions. NCGS 58-50-61(a)(17). (Refer to Glossary at http://www.nciom.org/hmoconguide/GLOSS31E.html)

Introduction

Utilization review is an important component of a quality assurance program. It is intended to monitor the care provided to patients and to detect patterns of over and underutilization. However, utilization review doesn’t stop at this point. It moves ahead by taking the utilization data and changing utilization practices among practitioners and providers to improve quality and promote effective utilization of medical resources.

In many medical facilities, utilization review extends to outpatient review services by reviewing requests for elective procedures and diagnostic testing. Utilization managers and staff will then work with the attending physicians to determine if clinical data support the benefits covered for the requests. In some medical facilities, this is called Demand Management.

Utilization review, or UR, as it is frequently called, was originally intended as a vehicle that addressed cost containment rather than the adequacy of patient care. Basically, UR is a cost containment technique.

UR can occur retrospectively or prospectively. When it is conducted retrospectively, it is primarily concerned with the review of services already rendered; however, when it is conducted prospectively it is used to authorize or refuse proposed treatments, referrals, and even hospital admissions. In the perspective mode, UR may have severe time restraints which if not met may cause harm to the patients. Medical conditions/diseases do not remain static during utilization review.

Another issue regarding UR is whether the employees or agents of a managed-care organization are practicing medicine when they make a determination whether a requested treatment is medically necessary.

Utilization review is an integral part of quality assurance. If managed properly it certainly can results in a higher quality of care while controlling costs. However, if and organizations’ utilization review program is inefficient and poorly managed it has the potential to harm patients and lower quality of care.

Required Reading

Anonymous. (2013). Does your organization have a utilization management committee? Medical Staff Briefing, 23(11), 1,3-5.

Frazier, K. (2014). Utilization Review Software: The Impact on Productivity and Structural Empowerment in Case Management Nurses in an Acute Care Setting. Gardner-Webb University.

Koike, A., Klap, R., & Unützer, J. (2014). Utilization management in a large managed behavioral health organization. Psychiatric Services.

Mullahy, C. M. (2014). The Case Manager’s Handbook, (5thed). Burlington, MA: Jones & Bartlett Learning. Retrieved from http://books.google.com/books?hl=en&lr=&id=iUPyAAAAQBAJ&oi=fnd&pg=PA12&dq=concurrent+utilization+review+programs+in+nursing+homes&ots=iorEmkFyuh&sig=4YnmC-9Hh6jCoi0rK2dH58NhoIM#v=onepage&q&f=false

NHS England provides funding for clinical utilization review programmes to improve patient flow. (2014). Professional Services Close – Up, Retrieved from http://search.proquest.com/docview/1518167158?accountid=28844

Olaniyan, O, Brown, I. L., & Williams, K. (2011). Concurrent utilization review; Getting it right. Physician Executive, 37(3), 50-54.

Plebani, M., Zaninotto, M., & Faggian, D. (2014). Utilization management: a European perspective. Clinica Chimica Acta, 427, 137-141.

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Sample Answer

Introduction to the healthcare facility

The healthcare facility identified is  Durham Veterans Affair healthcare (VA) in North Carolina. The healthcare facility provides services to military members, their families, and the retired veterans. The services provided in this healthcare facility include primary care, surgical services, audiology, ophthalmology, inpatient services, and outpatient services. It also has other ancillary departments such as laboratory and radiology departments The department has operating rooms for regular surgical procedures, cytography and angiography. All the healthcare departments in this facility must follow quality assurance procedures established by its department (Durham.va, 2015).

Utilization Management Program

The VA Durham utilization program is design in a manner that ensures delivery of quality and cost effective care to the service user. The utilization program is under the administrative and clinical direction  of the Medical advisory council and the Medical Advisory  vice president. The Medical advisory council is mandated to evaluate and approve the utilization management program every year.  In my place of work, the utilization program is manual. The overview of VA utilization management plan is a follows (Durham.va, 2015);

Referral system: All referrals are to be made by the Primary Care Physician (PCP) after consultation with a specialist at any time. However, no referrals are needed to treat emergency medical condition  unless it puts the patient’s health in jeopardy, potential impairment of body functions and dysfunction of a body organ.

Tertiary plan care: All tertiary care plans should be reviewed on an individual basis based on the patients immediate medical need and its availability. The specialist final decision of referrals will be evaluated by the  plan medical director.

Out-of-Plan Referrals: The requests  of healthcare provider outside  the health facility will be done on an individual basis based on the availability and patients needs  unless the patient’s  health status could be impacted negatively if out-of- plan referrals is denied.

Corporate Pre-service Review: Approval must be given before providing services. The main reason is to determine if the services is appropriate for the patient and the setting. Clinical information must be provided for all healthcare services that need clinical review. The Utilization Management staff should use plan documents to determine patient medical necessity coverage and  determining their benefits. Clinical information needed for clinical review  should be provided on the appropriate date and time. The clinical information must contain patient name, history of presenting disease, diagnostic results and the patient’s response to current treatment.

Inpatient  review: The staff assigned to follow member at  the acute care facility should collaborate with the facility healthcare providers so as to ensure ca continuum of care. The  facility staff and utilization management’s clinical staff will work in coordination to ensure that member’s discharge needs are met. All inpatient  should be reviewed before their admission to ensure that they have appropriate and adequate services according to pre-established medical necessity and benefits determinants. The admission will be approved accordingly of rescheduled  in appropriate timing and setting.

Concurrent review: The ongoing patient care will be reviewed and evaluated based on patients specific needs and  pre-established medical necessity. Discharge planning can begin at this time so as to plan for continuing quality care even after the patient is discharged.

Retrospective review: is performed after discharging the patient from a  healthcare facility. This should be implemented at when so as to monitor a patient’s progress after the patient was discharged when a physician was unavailable or when the healthcare facility fails to demonstrate that the patient condition meet criteria for a patient stay.

Discharge planning: the utilization manager coordinator will monitor the ongoing needs for the patient after discharge. Few days after discharge, follow up  phone calls should be done so as to identify members at high risk of becoming admitted. This is to ensure that the quality assurance is complied to and to assist in care coordination so as to  mitigate adverse outcomes.

Denials and Appeals: All denials will be given by the physician and must state the denial reason and contact information to discuss the denial. A written denial will be written and emailed to the Utilization management committee.

Critique of VA utilization management program

The main challenge of VA utilization program at my work place is that  it is an expensive manual resource that fails to engage the providers adequately, and often results into inefficient service for the service users (Anonymous, 2013).  For instance, 90% of pre-authorizations need  phone communications, which is time consuming and costs  up to $50-$80 costs per each authorization. In addition, it is estimated that about 15% of medical care procedures are unnecessary such as duplicative tests and hospitalizations.

Most of these  costs are attributable to inconsistencies observed during clinical decision making that occur when relying on the traditional manual utilization management processes and the incomplete coverage as necessary.  In addition, when healthcare providers have to wait until healthcare is delivered to deliberate on the event, it leads to missing of opportunities that will ensure cost effective quality care. In addition, the pre-authorization process that follows manual process  requires a great deal of investment as compared to an automated system that facilitates immediate approvals upon request, and to providers with appropriate guidance based on evidence based practice (Mullahy, 2014).

Areas for improvement in Utilization Management program

Some utilization management program changes will occur in the VA utilization program.  The driving force  for most of these changes includes advancement in organizational relationships and utilization management technologies. Effective utilization management is based on its ability to provide detailed yet coherent clinical information, and in providing clinical guidelines that define the most effective and appropriate care that will ensure positive patient outcomes (Mullahy, 2014).

As aforementioned, the VA programs are severely constrained due to inadequate  information to support informed and appropriate care  to a current diverse cohort of patients.  The VA Utilization Management program  should be transparent enough to ensure that the health providers and service users reach their decisions by eliminating contention and  improving optimized decision making processes that put into consideration patient’s preferences (Frazier, 2014).

The utilization management program should be designed to ensure that it s actionable. This implies that the plan recognizes its implication and automatically provides specific guidance  based on evidence based clinical guidelines. The plan should deliver relevant information  in real time so as to ensure that smooth quality workflow is sustained. This includes automating workflows so as to shorten the path to seek approval, providing rapid response and  lowering administrative burden in most of pthe atients, and simultaneously allowing the clinicians to focus on complex “exceptions” that truly needs their concentration and expertise (Koike, Klap, & Unatzer, 2014).

This implies that it is time to rely on  innovate technology that suit the VA health care facility missions and vision. It is important to work on these  decision support solutions so as to help the healthcare systems to provide value based care. This is process  requires  collaborative  efforts between the healthcare providers so as to make it a reality.

References

Durham.va (2015). Durham VA medical Center: Retrieved from http://www.durham.va.gov/

Anonymous. (2013). Does your organization have a utilization management committee? Medical Staff Briefing, 23(11), 1,3-5.

Frazier, K. (2014). Utilization Review Software: The Impact on Productivity and Structural Empowerment in Case Management Nurses in an Acute Care Setting. Gardner-Webb University.

Koike, A., Klap, R., & Unatzer, J. (2014). Utilization management in a large managed behavioral health organization. Psychiatric Services.

Mullahy, C. M. (2014). The Case Manager’s Handbook, (5thed). Burlington, MA: Jones & Bartlett Learning. Retrieved from http://books.google.com/books?hl=en&lr=&id=iUPyAAAAQBAJ&oi=fnd&pg=PA12&dq=concurrent+utilization+review+programs+in+nursing+homes&ots=iorEmkFyuh&sig=4YnmC-9Hh6jCoi0rK2dH58NhoIM#v=onepage&q&f=false

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