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description: This study examines the impact of implementing a default (opt-out) inpatient palliative care consultation order on hospitalization costs among older adults with serious chronic conditions. Specifically, it analyzes secondary data from the REDAPS randomized trial, which compared a default ordering approach to usual care (opt-in ordering) for palliative care consultations during hospital stays. The primary aim is to assess how the default intervention influences total and variable hospitalization costs relative to usual care. A secondary objective is to estimate the causal effect of actually receiving a palliative care consultation on hospitalization costs among patients who received one only because of the default order. Using electronic health record and administrative data from multiple hospitals, the analysis will include patients aged 65 and older with diagnoses of end-stage renal disease, chronic obstructive pulmonary disease, or dementia who meet specific clinical criteria. The study leverages a two-stage instrumental variables approach, using randomization to the default order as an instrument for palliative care receipt, to address potential selection bias and estimate the cost impact attributable to palliative care consultations. The study hypothesizes that default (opt-out) ordering does not increase hospitalization costs compared to usual care and that receiving palliative care reduces hospitalization costs among compliers to the default order. Beyond total cost outcomes, exploratory analyses will investigate cost differences across specific service categories and subgroups defined by clinical and demographic factors. Findings from this work aim to inform health system policies regarding palliative care integration by clarifying its economic implications in an inpatient setting.
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Kehidupan Beragama dalam Dinamika Pemuda Era Postmodern
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description: Abstrak Pada masa postmodern orang-orang mulai mempertanyakan sesuatu yang sudah mapan, tak terkecuali mempertanyakan eksistensi Tuhan. Di masa ini orang-orang muda pun tak luput dari cara berpikir seperti itu, mulai berpikir naif dan kecenderungan mereka untuk berpikir filosofis. Saat berdiskusi dengan temannya para pemuda memiliki kecenderungan untuk mempertanyakan keberadaan Tuhan. Entah itu karena untuk pemuasan hasrat keingintahuan mereka atau mengikuti alur zaman yang sedemikian rupa. Pola pikir tersebut memberikan dampak pada perilaku para pemuda yang mulai berubah. Hal yang paling tampak dari perubahan perilaku tersebut adalah perilaku agamis kemudian menjadi kurang. Penelitian ini bertujuan untuk mengetahui bagaimana pola pikir seseorang mempengaruhi kehidupan beragamanya. Hasil dari penelitian ini adalah pola pikir pemuda yang mempertanyakan eksistensi Tuhan tersebut mempengaruhi cara pandang mereka akan suatu hal seperti agama sehingga menyebabkan perilaku keagamaan mereka berubah. Kata kunci: Pola Pikir, Eksistensi Tuhan, Perilaku Beragama, Postmodern
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