Update: 10/4/2019 University of Maryland Global Campus (UMGC) HMGT 400 Research and Data Analysis in Health- FINAL EXAM Dataset: HMGTFINALEXAM.csv (Please download dataset from the class) Required program: RStudio or R Programming. Author, Hossein Zare, PhD Citation: Zare, H. (2019). HMGT 400 Research and Data Analysis in Health Care. FINAL EXAM. UMGC.EDU Question #1 (15 credits): [RStudio Users and Excel Users] The FINAL EXAM dataset, provides some information about hospitals in 2011 and 2012, download the FINAL EXAM data and then complete the descriptive table. Please answer the following questions. In term of hospital characters what are the significant difference between 2011 and 2012?In term of socio-economic variables what are the significant difference between 2011 and 2012?Based on your findings in which years hospitals had better performance? How hospital performance related to hospital characteristics and socio-economic characteristics? Please write at least three main different movements between 2011 and 2012. To report the “Per Capita Hospital Beds to Population”, you need to divide “total_hospital_beds/ tot_population) Table 1. Descriptive statistics between hospitals in 2011 & 2012 2011 2012 p-value N Mean St. Dev N Mean St. Dev Hospital Characteristics 1. Hospital beds 100 150 0.004 2. Number of paid Employee 3. Number of non-paid Employee 4. Internes and Residents 5. System Membership 6. Total hospital cost 7. Total hospital revenues 8. Hospital net benefit 9. Available Medicare days 10. Available Medicaid days 11. Total Hospital Discharge 12. Medicare discharge 13. Medicaid discharge Socio-Economic Variables 14. Per Capita Hospital Beds to Population 15. Percent of population under poverty 16. Percent of Female population under poverty 17. Percent of Male population under poverty 18. Median Household Income Question #2 (15 credits): [RStudio Users and Excel Users] Use the final exam dataset and then answer the following questions: Compare the following information between for-profit and non-for-profit hospitals.What are the main significant differences between for-profit and non-for-profit hospitals? Which test is the best fit test? Why?Use a box-plot and compare Hospital net benefit between for-profit and non-for-profit hospitals.Show another scatter plot and compare hospital cost (x-axes) and revenue (y-axes) and discuss your findings?Comparing hospital net-benefit which hospitals has better performance? To answer this question first compute the hospital net benefits with subtracting hospital costs and revenues and then use ttest to compare the significant differences between FP and NFP hospitals.Overall, what are the main significant differences between for-profit and non-for-profit hospitals? Table 2. Descriptive statistics between FP & NFP For Profit Non-For-Profit p-value N Mean St. Dev N Mean St. Dev Hospital Characteristics 1. Hospital beds 2. Number of paid Employee 3. Number of non-paid Employee 4. Internes and Residents 5. System Membership 6. Total hospital cost 7. Total hospital revenues 8. Hospital net benefit 1.5 1.75 0.03 9. Available Medicare days 10. Available Medicaid days 11. Total Hospital Discharge 12. Medicare discharge 13. Medicaid discharge Socio-Economic Variables 14. Per Capita Hospital Beds to Population 15. Percent of population under poverty 16. Percent of Female population under poverty 17. Percent of Male population under poverty 18. Median Household Income Question #3 (15 credits): [RStudio Users and Excel Users] The dataset provides Herfindahl–Hirschman Index for health insurance market, please use the herf_ins variable and answer the following questions: For this exercise you do not need to compute the HHI, but if you have any questions, please do not hesitate to ask me, but try to learn more about this you will need that to report your findings. Please remember for the class exercise you used the herf_cat as a hospital Herfindahl index. For this question make sure to use herf_ins as Herfindahl index for insurance market. Use the final exam dataset and then answer the following questions: In a short paragraph explain the Herfindahl index you can use the reference provided in the class exercise or any other citation.Compare the following information between hospitals located in high, moderate and low competitive health insurance markets? 2.1. What are the main significant differences between hospitals in different markets? (use Anova test)2.2. What is the impact of being in high-competitive health insurance market on hospital revenues and cost? 2.3. Do you think being in high-competitive market has positive impact on net hospital benefits? 2.4. What about the number of Medicare and Medicaid discharge? Do you think hospitals in higher completive market more likely to accept more Medicare and Medicaid patients? 2.5. What is the impact of other variables? (Note: to answer to the last question, please compute the ratio-Medicare-discharge and ratio-Medicaid-discharge first and then run 2 ttest) high vs. moderate and high vs. low competitive market), please support your findings with box-plot). Table 3. Comparing hospital characteristics and market, 2011 and 2012 High Competitive Market Moderate Competitive Market Low Competitive Market ANOVA/Chi-Sq (results) Hospital Characteristics N Mean STD N Mean STD N Mean STD 1. Hospital beds 2. Number of paid Employee 3. Number of non-paid Employee 4. Internes and Residents 5. System Membership 6. Total hospital cost 7. Total hospital revenues 8. Hospital net benefit 9. Available Medicare days 10. Available Medicaid days 11. Total Hospital Discharge 12. Medicare discharge-ratio 13. Medicaid discharge-ratio Socio-Economic Variables 14. Per Capita Hospital Beds to Population 15. Median Household Income Question #4 (Credits 20)- [RStudio Users] Linear Regression Model If you have chosen to work with RStudio, please run the following model and complete the following tables. 1st Model: Run a linear model and predict the difference between hospital beds (use the bed-tot) and hospital’s ownership on hospital net-benefit? Discuss your finding, do you think having higher beds has positive impact on the hospital net benefit? What about the ownership? Model 1a Hospital Characteristics Coef. St. Err p-value Hospital beds Ownership For Profit Non-for profit Ref. Ref. Ref. Other N R-Squared 2nd Model: Now, estimate the impact of being a member of a system on hospital net benefit? And discuss your finding (nor more than 2 lines)? Is it significant? Model 2 Hospital Characteristics Coef. St. Err p-value Hospital beds Ownership For Profit Non-for profit Other Membership System Membership N R-Squared 3nd Model: Now, include the ratio of ratio-Medicare-discharge and ratio-Medicaid-discharge in your model? How do you evaluate the impact of having higher Medicare and Medicaid patients on hospital revenues? Model 3 Hospital Characteristics Coef. St. Err p-value Hospital beds Ownership For Profit Non-for profit Other Membership System Membership Socio-Economic Characteristics Medicare discharge ratio Medicaid discharge ratio N R-Squared Based on your finding please recommend 3 policies to improve hospital performance, please make sure to use the final model for your recommendation. Discuss your findings. Question #4 (Credits 20)- [Excel Users] Linear Regression Model If you have chosen to work with Excel, please run the models and complete the following tables. Model 1: Run a linear model and predict the difference between hospital beds (use the bed-tot) and hospital net-benefit in teaching hospitals?Y(benefit), B0+B1(beds) Hospital Characteristics Coef. ST. ERR T Stat P-values Lower 95% Upper 95% Model-1 Hospital beds N R Square Model 2: Run a linear model and predict the difference between hospital beds (use the bed-tot) and hospital net-benefit in non-teaching hospitals? Use the results from model 1 and model 2 and compare the results between teaching and non-teaching hospitals. Hospital Characteristics Coef. ST. ERR T Stat P-values Lower 95% Upper 95% Model-2 Hospital beds N R Square Model 3: Now, include the ratio of ratio-Medicare-discharge and ratio-Medicaid-discharge in first model? How do you evaluate the impact of having higher Medicare and Medicaid patients on hospital net-benefit in teaching hospitals? Hospital Characteristics Coef. ST. ERR T Stat P-values Lower 95% Upper 95% Model-3 Hospital beds ratio-Medicare-discharge ratio-Medicaid-discharge N R Square Model 4: Now, include the ratio of ratio-Medicare-discharge and ratio-Medicaid-discharge in first model? How do you evaluate the impact of having higher Medicare and Medicaid patients on hospital net-benefit in non-teaching hospitals? Hospital Characteristics Coef. ST. ERR T Stat P-values Lower 95% Upper 95% Model-4 Hospital beds ratio-Medicare-discharge ratio-Medicaid-discharge N R Square Based on your finding please recommend 3 policies to improve hospital performance, please make sure to use the final model for your recommendation. Question #5 (Credits 20) [RStudio Users] If you have chosen to work with RStudio, please run three models and complete the following tables. Model 1: Run a logit model and use being a member of network and find out its impact on hospital beds and hospital ownership? (Model 1) Hospital Characteristics Coef. St. Err p-value Hospital beds Ownership For Profit Non-for profit Other N AIC Model 2: Now, include hospital revenue and report the Coeff.? (Model 2) Hospital Characteristics Coef. St. Err p-value Hospital beds Ownership For Profit Non-for profit Other Hospital revenue N AIC Model 3: Now, include the ratio of ratio-Medicare-discharge and ratio-Medicaid-discharge in your model? And keep all variables you used for models 1, 2 & 3 and discuss your findings? Do you recommend keeping membership for a hospital? Why or why not? (Model 3) Hospital Characteristics Coef. St. Err p-value Hospital beds Ownership For Profit Non-for profit Other Hospital revenue Medicare discharge ratio Medicaid discharge ratio N AIC Based on your finding please recommend 3 policies to improve hospital performance in FP, NFP hospitals, please make sure to use the final model for your recommendation. Question #5 (Credits 20)- [Excel users] If you have chosen to work with Excel, please run above three models and complete the following tables. Model 1: Run a regression model and use being a member of network and find out its impact on hospital cost? (Model 1) Coef. ST. ERR T Stat P-values Lower 95% Upper 95% Model-1 Hospital cost N R Square Model 2: For the 2nd model run a regression model and use being a member of network and find out its impact on hospital cost and hospital revenue? (Model 2) Coef. ST. ERR T Stat P-values Lower 95% Upper 95% Model-2 Hospital cost Hospital Revenue N R Square Model 3: For the 3rd model run a regression model and use being a member of network and find out its impact on ratio-Medicare-discharge and ratio-Medicaid-discharge. Coef. ST. ERR T Stat P-values Lower 95% Upper 95% Model-3 Hospital cost Hospital Revenue Medicare discharge ratio Medicaid discharge ratio N R Square Based on your finding please recommend 3 policies and discuss the impact of being on a network on hospital cost, hospital revenue and out its impact on ratio-Medicare-discharge and ratio-Medicaid-discharge. Do you recommend keeping membership for a hospital? Why or why not? Question 6: (15 credits) [RStudio Users and Excel Users]] 1. Please offer a research question for the study using human subject research. 2. Explain the difference between the research process involving human subjects and the research process not involving human subjects. 3. Discuss ethical implications surrounding human subject research studies. 4. Explain the governance of the human subject research studies over the data and the process. 5. Provide examples of the consequences for not meeting IRB (Institutional Review Board) protocol requirements. LINK to DATA: https://drive.google.com/file/d/0B1N15WfHIN43c3RhcnRlcl9maWxl/view?usp=sharing, https://docs.google.com/document/d/1ePoFxp8nXMgOlNO4vHnWWVe4KZll_5R_riC7bSLjdC0/edit?usp=sharing, https://drive.google.com/file/d/1lguv1FDlVyF5xWKAT_TCvxQF6WDKNCxe/view?usp=sharing, https://drive.google.com/file/d/1pGOnhP0VK5hjLMntb...