Nilmar Daniel - Academia.edu (original) (raw)
Papers by Nilmar Daniel
JAMA: The Journal of the American Medical Association, 1992
To compare quality of care measured by explicit criteria, implicit review, and sickness-adjusted ... more To compare quality of care measured by explicit criteria, implicit review, and sickness-adjusted outcomes at different types of hospitals. Further analysis of data retrospectively abstracted from medical records to evaluate the effects of prospective payment on quality of care for hospitalized Medicare patients. Hospitals in five states were sampled to represent the national Medicare admissions along many dimensions. A total of 14,008 elderly patients with one of the following five diseases: congestive heart failure, acute myocardial infarction, pneumonia, stroke, or hip fracture. These patients were randomly sampled from those with these diseases in 297 hospitals in two time periods, 1981 to 1982 and 1985 to 1986. Explicit criteria, implicit review, and mortality within 30 days of admission adjusted for sickness at admission. Quality of care ratings for hospital types are similar using explicit criteria, implicit review, and outcomes adjusted for sickness at admission. Quality differences between types of hospitals were large, with the lowest group estimated to have four percentage points higher mortality than major teaching hospitals in a cohort of patients with average mortality of 16%. Quality varies from state to state, but teaching, larger, and more urban hospitals have better quality in general than nonteaching, small, and rural hospitals. Hospital quality persists over time, but small nonteaching hospitals narrowed the gap with better quality hospitals between 1981 and 1986. The different measures led to consistent and plausible relationships between quality and hospital characteristics. Thus, valid information about hospital quality can be obtained. We need to develop ways to use such information to improve care.
Resumo O presente texto tem por objetivo analisar o enlace dos conceitos de educação, moralidade ... more Resumo O presente texto tem por objetivo analisar o enlace dos conceitos de educação, moralidade e comunidade cosmopolita no âmbito da filosofia prática kantiana. Desse modo, pretende-se seguir o percurso desses conceitos, considerando a rudeza e as influências brutas que pertencem ao estado de natureza humana, que, necessariamente carece de disciplina e instrução como suporte e orientação aos princípios do agir moral. Nesse sentido, será explanado o desenlace do progresso e o aperfeiçoamento da espécie humana que ocorre na perspectiva de um sistema cosmopolita unificado são condições de possibilidade à maioridade ética. Palavras-chave: Sistema cosmopolita unificado. Instrução. Maioridade ética. Abstract This text aims to analyze the linkage of the concepts of education, morality and cosmopolitan community in the context of Kant's practical philosophy. Thus, I intend to follow the path of these concepts, considering the rudeness and gross influences belonging to the state of hum...
O presente texto tem por objetivo analisar o enlace dos conceitos de educacao, moralidade ecomuni... more O presente texto tem por objetivo analisar o enlace dos conceitos de educacao, moralidade ecomunidade cosmopolita no âmbito da filosofia pratica kantiana. Desse modo, pretende-seseguir o percurso desses conceitos, considerando a rudeza e as influencias brutas quepertencem ao estado de natureza humana, que, necessariamente carece de disciplina einstrucao como suporte e orientacao aos principios do agir moral. Nesse sentido, seraexplanado o desenlace do progresso e o aperfeicoamento da especie humana que ocorre naperspectiva de um sistema cosmopolita unificado sao condicoes de possibilidade a maioridadeetica.
JAMA: The Journal of the American Medical Association, 1992
To compare quality of care measured by explicit criteria, implicit review, and sickness-adjusted ... more To compare quality of care measured by explicit criteria, implicit review, and sickness-adjusted outcomes at different types of hospitals. Further analysis of data retrospectively abstracted from medical records to evaluate the effects of prospective payment on quality of care for hospitalized Medicare patients. Hospitals in five states were sampled to represent the national Medicare admissions along many dimensions. A total of 14,008 elderly patients with one of the following five diseases: congestive heart failure, acute myocardial infarction, pneumonia, stroke, or hip fracture. These patients were randomly sampled from those with these diseases in 297 hospitals in two time periods, 1981 to 1982 and 1985 to 1986. Explicit criteria, implicit review, and mortality within 30 days of admission adjusted for sickness at admission. Quality of care ratings for hospital types are similar using explicit criteria, implicit review, and outcomes adjusted for sickness at admission. Quality differences between types of hospitals were large, with the lowest group estimated to have four percentage points higher mortality than major teaching hospitals in a cohort of patients with average mortality of 16%. Quality varies from state to state, but teaching, larger, and more urban hospitals have better quality in general than nonteaching, small, and rural hospitals. Hospital quality persists over time, but small nonteaching hospitals narrowed the gap with better quality hospitals between 1981 and 1986. The different measures led to consistent and plausible relationships between quality and hospital characteristics. Thus, valid information about hospital quality can be obtained. We need to develop ways to use such information to improve care.
Resumo O presente texto tem por objetivo analisar o enlace dos conceitos de educação, moralidade ... more Resumo O presente texto tem por objetivo analisar o enlace dos conceitos de educação, moralidade e comunidade cosmopolita no âmbito da filosofia prática kantiana. Desse modo, pretende-se seguir o percurso desses conceitos, considerando a rudeza e as influências brutas que pertencem ao estado de natureza humana, que, necessariamente carece de disciplina e instrução como suporte e orientação aos princípios do agir moral. Nesse sentido, será explanado o desenlace do progresso e o aperfeiçoamento da espécie humana que ocorre na perspectiva de um sistema cosmopolita unificado são condições de possibilidade à maioridade ética. Palavras-chave: Sistema cosmopolita unificado. Instrução. Maioridade ética. Abstract This text aims to analyze the linkage of the concepts of education, morality and cosmopolitan community in the context of Kant's practical philosophy. Thus, I intend to follow the path of these concepts, considering the rudeness and gross influences belonging to the state of hum...
O presente texto tem por objetivo analisar o enlace dos conceitos de educacao, moralidade ecomuni... more O presente texto tem por objetivo analisar o enlace dos conceitos de educacao, moralidade ecomunidade cosmopolita no âmbito da filosofia pratica kantiana. Desse modo, pretende-seseguir o percurso desses conceitos, considerando a rudeza e as influencias brutas quepertencem ao estado de natureza humana, que, necessariamente carece de disciplina einstrucao como suporte e orientacao aos principios do agir moral. Nesse sentido, seraexplanado o desenlace do progresso e o aperfeicoamento da especie humana que ocorre naperspectiva de um sistema cosmopolita unificado sao condicoes de possibilidade a maioridadeetica.