| Course | HCAD 9000 Healthcare Administration Dissertation |
|---|---|
| Week | Week 6 |
| Paper type | Results chapter narrative |
| Length | About 1,020 words, 6 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | PhD in Healthcare Administration |
| Updated | October 2026 |
Free sample paper for HCAD 9000 Week 6
Chapter 4 Results by Research Question: Referral Completeness, Timeliness and the Role of Record Conversion After Acquisition, Told in the Questions' Own Words
Student Name
Walden University
HCAD 9000: Healthcare Administration Dissertation
Instructor Name
Month Day, Year
Chapter 4 Results by Research Question: Referral Completeness, Timeliness and the Role of Record Conversion After Acquisition, Told in the Questions' Own Words
Overview of the Chapter
This chapter reports the results for the three research questions in the order they were asked in Chapter 1. Each section restates its question, points to the table that carries the values, characterizes what was found, including which way it ran and how large it was, and closes by stating what the finding does not show. Interpretation is left to Chapter 5. The sample comprised 4,186 referrals from 14 acquired and 22 comparison primary care practices to the cardiology, gastroenterology, neurology and orthopedic clinics of Cedar Basin Health, a composite name for the study system, across ten six-month periods spanning 2021 to 2025. The eight index items follow the gaps that primary care physicians and specialists most often report in referral communication (O'Malley & Reschovsky, 2011). Inter-rater agreement on the completeness index is reported in Appendix B; item-level kappa values ranged from 0.69 to 0.88, with a mean of 0.78 (Cohen, 1960).
Research Question 1
Research Question 1 asked: "Did the completeness of referral information sent from primary care practices to the system's specialists change after those practices were acquired, relative to practices that were not acquired?"
Table 1 reports the mean completeness score, out of eight items, for each group before and after acquisition, along with the difference-in-differences estimate from the staggered-adoption model (Callaway & Sant'Anna, 2021).
Completeness rose in acquired practices after acquisition and changed little in comparison practices. The difference between the groups' changes was about one item on the eight-item index, and the confidence interval excluded zero. Before acquisition the two groups' scores moved together across periods; the pre-period estimates are shown in Figure 1 and did not differ from zero. Item-level results appear in Table 2. Six of the eight items increased in acquired practices. The two largest increases were for the current medication list and recent laboratory results. The item for a specific clinical question did not change in either group.
This finding does not show that acquisition caused the change in the strict sense, and it does not show any change in clinical outcomes, which the study did not measure.
Table 2
Share of Referrals Containing Each Item, Acquired Practices Before and After Acquisition
| Item | Before | After | |
|---|---|---|
| Reason for referral | 94% | 96% | |
| Specific clinical question | 31% | 30% | |
| Relevant history | 58% | 66% | |
| Current medication list | 41% | 74% | |
| Allergies | 47% | 72% | |
| Recent laboratory results | 36% | 69% | |
| Recent imaging | 29% | 48% | |
| Stated urgency | 52% | 55% | |
Shares for comparison practices appear in Appendix D and changed by no more than four percentage points on any item.
Research Question 2
Research Question 2 asked: "Did the timeliness of referral information, defined as its presence in the specialist's record ahead of the first scheduled visit, change after acquisition, relative to practices that were not acquired?"
Table 3 reports the share of referrals whose information was in the specialist's record before the first visit.
Timeliness rose in acquired practices and changed slightly in comparison practices. Pre-period estimates did not differ from zero. The increase in acquired practices was larger in cardiology and gastroenterology than in neurology and orthopedics; specialty-level estimates appear in Appendix D.
In comparison practices, the share of timely referrals moved within a band of five percentage points across all ten periods, with no period standing out. The rise in acquired practices was concentrated in the periods after record conversion, as Research Question 3 reports. This finding does not show that patients were seen sooner or that the information was read before the visit; the measure records only whether it was available.
Table 3
Referral Information Present Before the First Specialist Visit, Research Question 2
| Group | Before acquisition | After acquisition | Change (percentage points) | |
|---|---|---|---|
| Acquired practices (14) | 51% | 74% | +23 | |
| Comparison practices (22) | 54% | 58% | +4 | |
| Difference-in-differences estimate | n/a | n/a | +19 (95% CI 13 to 25) | |
Timeliness is coded at the referral level; a referral is timely when all documents sent arrived before the first scheduled visit.
Research Question 3
Research Question 3 asked: "Did any change in the completeness or timeliness of referral information after acquisition depend on the acquired practice's conversion to the system's electronic health record?" As described in Chapter 3, the question entered the study once data collection was underway, so its results are exploratory.
Table 4 divides the post-acquisition period of each acquired practice into the months before record conversion and the months after.
In the months between acquisition and conversion, completeness and timeliness in acquired practices were essentially unchanged from their levels before acquisition. After conversion, both rose. The averages reported under Research Questions 1 and 2 combine these two periods, which is why they are smaller than the post-conversion values in Table 4. The pattern held in each of the four specialties. Because practices with later conversion dates contribute fewer post-conversion periods, the post-conversion estimate draws more heavily on the practices that converted early.
This finding does not show that record conversion alone produced the change, because conversion coincided with other changes the system made, such as staff training on referral orders, which the study could not separate.
Table 4
Completeness and Timeliness by Record Conversion Status, Acquired Practices, Research Question 3
| Period | Completeness score (0-8) | Information present before visit | |
|---|---|---|
| Before acquisition | 3.9 | 51% | |
| After acquisition, before conversion | 3.9 | 52% | |
| After conversion | 6.2 | 83% | |
| Comparison practices, matching periods | 4.1 to 4.3 | 54% to 58% | |
Conversion followed acquisition by a median of 14 months (range 6 to 29). The estimate for completeness after conversion relative to comparison practices was +2.0 items (95% CI 1.6 to 2.4).
Findings Outside the Research Questions
Two results fall outside the questions asked. First, the item for a specific clinical question remained near 30% in every group and period, including after conversion. Second, in three acquired practices, completeness fell in the first period after conversion before rising, which corresponded to the months in which staff were learning the new record system. These are reported here for completeness and are not tested.
References
Callaway, B., & Sant'Anna, P. H. C. (2021). Difference-in-differences with multiple time periods. Journal of Econometrics, 225(2), 200-230. https://doi.org/10.1016/j.jeconom.2020.12.001
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20(1), 37-46. https://doi.org/10.1177/001316446002000104
O'Malley, A. S., & Reschovsky, J. D. (2011). Referral and consultation communication between primary care and specialist physicians: Finding common ground. Archives of Internal Medicine, 171(1), 56-65. https://doi.org/10.1001/archinternmed.2010.480
Reading the HCAD 9000 Week 6 instructions
The results chapter reports what you found, question by question, and stops short of explaining why. Organize it by research question, in the order you asked them. Open each section by quoting the question exactly as Chapter 1 states it, so the terms cannot drift. Point to the table or figure that holds the values, then describe the direction and character of the finding in words without reciting every row. Report unexpected findings in the same tone as expected ones. End each section by saying what the finding does not show. If a question was added late, label its results exploratory. Close with anything you found outside your questions, reported briefly and without testing.
Inside the HCAD 9000 Week 6 example
The sample opens with an overview giving the sample, setting and agreement statistics, citing O'Malley and Reschovsky for the index items and Cohen for kappa. The first question's section quotes the question, points to Table 1 with the difference-in-differences estimate from Callaway and Sant'Anna's approach and Table 2 with item-level shares, and notes that the specific clinical question did not change. The second section presents timeliness in Table 3. The third, labeled exploratory, uses Table 4 to divide the post-acquisition period at record conversion. Each ends with a sentence on what the result does not show. A final section notes two findings outside the questions.
Where the marks sit in the HCAD 9000 Week 6 rubric
Faculty grade a results chapter mainly on the line between reporting and interpreting. Crossing it costs credit here and again in the discussion. Sections that answer every research question are expected, and a question left unanswered is a serious weakness. Quoting each question exactly earns credit because it keeps terms consistent across a long document. Tables should stand on their own, with titles and notes that make them readable without the text. Prose that characterizes rather than recites is valued. Unexpected results reported plainly, rather than moved to an appendix, show integrity. A closing sentence on what each finding does not show is often what separates strong chapters. Faculty check that labels in the text match labels in the tables.
HCAD 9000 Week 6 help from the desk
The hardest part of a results chapter is resisting the urge to explain. Write each section in three moves: the question, the pointer to the table, the description. If you find yourself writing "because" or "this suggests," move that sentence to your discussion notes. Quote your research questions word for word from Chapter 1. Make sure every table can be read alone. Report findings that went the wrong way with the same care as the rest. End each section by naming what your result does not show, which protects you at the defense. We can help you organize your own output into a chapter that reports cleanly. Check every number in the text against its table before you send the draft.
Get a HCAD 9000 Week 6 example written to your instructions
Supply the research questions in their current wording, plus the prompt and a copy of the rubric. The narrative written against them keeps reporting and pointing apart, section by section. Nothing is billed for the first, it is shaped to the questions you send, and it reaches you 24 to 48 hours after you ask.
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HCAD 9000 Week 6 questions, answered
Where can I find a free HCAD 9000 Week 6 sample paper?
The results chapter for a referral study, organized by research question with four tables and references, is free to read here.
How does the HCAD 9000 Week 6 example open each section?
By quoting the research question exactly as Chapter 1 states it, so terms stay consistent.
Where do the numbers appear?
In the tables; the prose points to each table and describes the direction and size of the finding without reciting rows.
What does the third research question show?
Completeness and timeliness stayed flat between acquisition and record conversion and rose afterward, reported as exploratory.
Are the values in the sample real?
They come from a composite study written for illustration; a candidate's own analysis output replaces them.