# final assigment 1

Update: 10/4/2019

University of Maryland Global Campus (UMGC)
HMGT 400 Research and Data Analysis in Health- FINAL EXAM
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 â€œPer Capita Hospital Beds to Populationâ€, you need to divide â€œtotal_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 Herfindahlâ€“Hirschman Index for health insurance market, please use the herf_ins variable and answer the following questions:
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 hospitalâ€™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.

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 variab

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