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Health Services Research

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https://www.readbyqxmd.com/read/28294328/the-longitudinal-association-between-psychological-factors-and-health-care-use
#1
Jens-Oliver Bock, André Hajek, Hans-Helmut König
OBJECTIVE: Little attention has been given to psychological factors as correlates of health care use, which could be an important key to manage it. We analyzed the association of psychological factors with health care use. DATA SOURCES: Primary data were obtained from three follow-ups (2002, 2008, and 2011) of a large population-based study with participants aged 40+. STUDY DESIGN: Using a longitudinal observational study, we analyzed the psychological factors of negative and positive affect (affective well-being), life satisfaction (cognitive well-being), self-efficacy, loneliness, self-esteem, optimism, and flexible goal adjustment using fixed-effects regressions...
March 15, 2017: Health Services Research
https://www.readbyqxmd.com/read/28295278/improving-hospital-performance-rankings-using-discrete-patient-diagnoses-for-risk-adjustment-of-outcomes
#2
Brendan DeCenso, Herbert C Duber, Abraham D Flaxman, Shane M Murphy, Michael Hanlon
OBJECTIVE: To assess the changes in patient outcome prediction and hospital performance ranking when incorporating diagnoses as risk adjusters rather than comorbidity indices. DATA SOURCES: Healthcare Cost and Utilization Project State Inpatient Databases for New York State, 2005-2009. STUDY DESIGN: Conducted tree-based classification for mortality and readmission by incorporating discrete patient diagnoses as predictors, comparing with traditional comorbidity indices such as those used for Centers for Medicare and Medicaid Services (CMS) outcome models...
March 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/28295261/the-role-of-medicare-s-inpatient-cost-sharing-in-medicaid-entry
#3
Laura M Keohane, Amal N Trivedi, Vincent Mor
OBJECTIVE: To isolate the effect of greater inpatient cost-sharing on Medicaid entry among Medicare beneficiaries. DATA SOURCES: Medicare administrative data (years 2007-2010) were linked to nursing home assessments and area-level socioeconomic indicators. STUDY DESIGN: Medicare beneficiaries who are readmitted to a hospital must pay an additional deductible ($1,100 in 2010) if their readmission occurs more than 59 days following discharge...
March 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/28295260/hospital-readmission-and-social-risk-factors-identified-from-physician-notes
#4
Amol S Navathe, Feiran Zhong, Victor J Lei, Frank Y Chang, Margarita Sordo, Maxim Topaz, Shamkant B Navathe, Roberto A Rocha, Li Zhou
OBJECTIVE: To evaluate the prevalence of seven social factors using physician notes as compared to claims and structured electronic health records (EHRs) data and the resulting association with 30-day readmissions. STUDY SETTING: A multihospital academic health system in southeastern Massachusetts. STUDY DESIGN: An observational study of 49,319 patients with cardiovascular disease admitted from January 1, 2011, to December 31, 2013, using multivariable logistic regression to adjust for patient characteristics...
March 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/28295249/development-and-validation-of-the-modified-patient-centered-medical-home-assessment-for-the-comprehensive-primary-care-initiative
#5
Dmitriy Poznyak, Deborah N Peikes, Breanna A Wakar, Randall S Brown, Robert J Reid
OBJECTIVE: To describe the modified Patient-Centered Medical Home Assessment (M-PCMH-A) survey module developed to track primary care practices' care delivery approaches over time, assess whether its underlying factor structure is reliable, and produce factor scores that provide a more reliable summary measure of the practice's care delivery than would a simple average of question responses. DATA SOURCES/STUDY SETTING: Survey data collected from diverse practices participating in the Comprehensive Primary Care (CPC) initiative in 2012 (n = 497) and 2014 (n = 493) and matched comparison practices in 2014 (n = 423)...
March 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/28294310/longitudinal-analysis-of-quality-of-diabetes-care-and-relational-climate-in-primary-care
#6
Marina Soley-Bori, Justin K Benzer, James F Burgess
OBJECTIVE: To assess the influence of relational climate on quality of diabetes care. DATA SOURCES/STUDY SETTING: The study was conducted at the Department of Veterans Affairs (VA). The VA All Employee Survey (AES) was used to measure relational climate. Patient and facility characteristics were gathered from VA administrative datasets. STUDY DESIGN: Multilevel panel data (2008-2012) with patients nested into clinics. DATA COLLECTION/EXTRACTION METHODS: Diabetic patients were identified using ICD-9 codes and assigned to the clinic with the highest frequency of primary care visits...
March 10, 2017: Health Services Research
https://www.readbyqxmd.com/read/28266025/impact-of-the-local-public-hospital-reform-on-the-efficiency-of-medium-sized-hospitals-in-japan-an-improved-slacks-based-measure-data-envelopment-analysis-approach
#7
Xing Zhang, Kaoru Tone, Yingzhe Lu
OBJECTIVE: To assess the change in efficiency and total factor productivity (TFP) of the local public hospitals in Japan after the local public hospital reform launched in late 2007, which was aimed at improving the financial capability and operational efficiency of hospitals. DATA SOURCES AND DATA COLLECTION: Secondary data were collected from the Ministry of Internal Affairs and Communications on 213 eligible medium-sized hospitals, each operating 100-400 beds from FY2006 to FY2011...
March 6, 2017: Health Services Research
https://www.readbyqxmd.com/read/28255995/meaningful-use-and-hospital-performance-on-post-acute-utilization-indicators
#8
Yanick N Brice, Karen E Joynt, Christopher P Tompkins, Grant A Ritter
OBJECTIVES: To examine trends in hospital post-acute utilization indicators and to determine whether improvement in these indicators is associated with attesting to meaningful use (MU). DATA SOURCES: Medicare claims-based, repeated measures on 30-day hospital-wide all-cause readmission and emergency department (ED) utilization rates for 160 short-stay hospitals (2009-2012); Medicare EHR Incentive Program Payments files (2011-2012); and other hospital and market data...
March 2, 2017: Health Services Research
https://www.readbyqxmd.com/read/28255992/the-reduction-in-ed-and-hospital-admissions-in-medical-home-practices-is-specific-to-primary-care-sensitive-chronic-conditions
#9
Lee A Green, Hsiu-Ching Chang, Amanda R Markovitz, Michael L Paustian
OBJECTIVE: To determine whether the Patient-Centered Medical Home (PCMH) transformation reduces hospital and ED utilization, and whether the effect is specific to chronic conditions targeted for management by the PCMH in our setting. DATA SOURCES AND STUDY SETTING: All patients aged 18 years and older in 2,218 primary care practices participating in a statewide PCMH incentive program sponsored by Blue Cross Blue Shield of Michigan (BCBSM) in 2009-2012. STUDY DESIGN: Quantitative observational study, jointly modeling PCMH-targeted versus other hospital admissions and ED visits on PCMH score, patient, and practice characteristics in a hierarchical multivariate model using the generalized gamma distribution...
March 2, 2017: Health Services Research
https://www.readbyqxmd.com/read/28255988/differences-between-proxy-and-patient-assessments-of-cancer-care-experiences-and-quality-ratings
#10
Jessica K Roydhouse, Roee Gutman, Nancy L Keating, Vincent Mor, Ira B Wilson
OBJECTIVE: To assess the impact of proxy survey responses on cancer care experience reports and quality ratings. DATA SOURCES/STUDY SETTING: Secondary analysis of data from Cancer Care Outcomes Research and Surveillance (CanCORS). Recruitment occurred from 2003 to 2005. STUDY DESIGN: The study was a cross-sectional observational study. The respondents were patients with incident colorectal or lung cancer or their proxies. DATA COLLECTION/EXTRACTION METHODS: Analyses used linear regression models with an independent variable for proxy versus patient responses as well as study site and clinical covariates...
March 2, 2017: Health Services Research
https://www.readbyqxmd.com/read/28217974/home-health-care-nurse-physician-communication-patient-severity-and-hospital-readmission
#11
Michael F Pesko, Linda M Gerber, Timothy R Peng, Matthew J Press
OBJECTIVE: To evaluate whether communication failures between home health care nurses and physicians during an episode of home care after hospital discharge are associated with hospital readmission, stratified by patients at high and low risk of readmission. DATA SOURCE/STUDY SETTING: We linked Visiting Nurse Services of New York electronic medical records for patients with congestive heart failure in 2008 and 2009 to hospitalization claims data for Medicare fee-for-service beneficiaries...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28217969/postponing-a-general-practitioner-visit-describing-social-differences-in-thirty-one-european-countries
#12
Jens Detollenaere, Amelie Van Pottelberge, Lise Hanssens, Lieven Pauwels, Tessa van Loenen, Sara Willems
OBJECTIVE: To describe social differences in postponing a general practitioner visit in 31 European countries and to explore whether primary care strength is associated with postponement rates. DATA SOURCES: Between October 2011 and December 2013, the multicountry QUALICOPC study collected data on 61,931 patients and 7,183 general practitioners throughout Europe. STUDY DESIGN: Access to primary care was measured by asking the patients whether they postponed a general practitioner visit in the past year...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28217968/payer-type-and-low-value-care-comparing-choosing-wisely-services-across-commercial-and-medicare-populations
#13
Carrie H Colla, Nancy E Morden, Thomas D Sequist, Alexander J Mainor, Zhonghe Li, Meredith B Rosenthal
OBJECTIVE: To compare low-value health service use among commercially insured and Medicare populations and explore the influence of payer type on the provision of low-value care. DATA SOURCES: 2009-2011 national Medicare and commercial insurance administrative data. DESIGN: We created claims-based algorithms to measure seven Choosing Wisely-identified low-value services and examined the correlation between commercial and Medicare overuse overall and at the regional level...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28217941/combining-internet-based-and-postal-survey-methods-in-a-survey-among-gynecologists-results-of-a-randomized-trial
#14
Sinja Alexandra Ernst, Tilman Brand, Stefan K Lhachimi, Hajo Zeeb
OBJECTIVE: To assess whether a combination of Internet-based and postal survey methods (mixed-mode) compared to postal-only survey methods (postal-only) leads to improved response rates in a physician survey, and to compare the cost implications of the different recruitment strategies. DATA SOURCES/STUDY SETTING: All primary care gynecologists in Bremen and Lower Saxony, Germany, were invited to participate in a cross-sectional survey from January to July 2014. STUDY DESIGN: The sample was divided into two strata (A; B) depending on availability of an email address...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28217938/impact-of-provider-competition-under-global-budgeting-on-the-use-of-cesarean-delivery
#15
Bradley Chen, Chin-Shyan Chen, Tsai-Ching Liu
OBJECTIVE: To examine the impact of provider competition under global budgeting on the use of cesarean delivery in Taiwan. DATA SOURCES/STUDY SETTING: (1) Quarterly inpatient claims data of all clinics and hospitals with birth-related expenses from 2000 to 2008; (2) file of health facilities' basic characteristics; and (3) regional quarterly point values (price conversion index) for clinics and hospitals, respectively, from the fourth quarter in 1999 to the third quarter in 2008, from the Statistics of the National Health Insurance Administration...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28217876/identifying-primary-care-pathways-from%C3%A2-quality-of-care-to-outcomes-and-satisfaction-using-structural-equation-modeling
#16
Ignacio Ricci-Cabello, Sarah Stevens, Andrew R H Dalton, Robert I Griffiths, John L Campbell, Jose M Valderas
OBJECTIVE: To study the relationships between the different domains of quality of primary health care for the evaluation of health system performance and for informing policy decision making. DATA SOURCES: A total of 137 quality indicators collected from 7,607 English practices between 2011 and 2012. STUDY DESIGN: Cross-sectional study at the practice level. Indicators were allocated to subdomains of processes of care ("quality assurance," "education and training," "medicine management," "access," "clinical management," and "patient-centered care"), health outcomes ("intermediate outcomes" and "patient-reported health status"), and patient satisfaction...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28176307/do-people-with-health-insurance-coverage-who-live-in-areas-with-high-uninsurance-rates-pay-more-for-emergency-department-visits
#17
James B Kirby, Joel W Cohen
OBJECTIVE: To investigate the relationship between the percent uninsured in a county and expenditures associated with the typical emergency department visit. DATA SOURCES: The Medical Expenditure Panel Survey linked to county-level data from the American Community Survey, the Healthcare Cost and Utilization Project, and the Area Health Resources Files. STUDY DESIGN: We use a nationally representative sample of emergency department visits that took place between 2009 and 2013 to estimate the association between the percent uninsured in counties and the amount paid for a typical visit...
February 7, 2017: Health Services Research
https://www.readbyqxmd.com/read/28138988/telemedical-care-and-monitoring-for-patients-with-chronic-heart-failure-has-a-positive-effect-on-survival
#18
Robert Herold, Neeltje van den Berg, Marcus Dörr, Wolfgang Hoffmann
BACKGROUND: Telemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies. The utility in routine care remains unclear. METHODS: We evaluated a large-sized telemedicine program in a routine care setting, enrolling in total 2,622 patients (54.7 percent male, mean age: 73.7 years) with chronic heart failure. We used reimbursement data from a large statutory health insurance and approached a matched control analysis...
January 31, 2017: Health Services Research
https://www.readbyqxmd.com/read/28127752/malpractice-claim-fears-and-the-costs-of-treating-medicare-patients-a-new-approach-to-estimating-the-costs-of-defensive-medicine
#19
James D Reschovsky, Cynthia B Saiontz-Martinez
OBJECTIVE: To estimate the cost of defensive medicine among elderly Medicare patients. DATA SOURCES: We use a 2008 national physician survey linked to respondents' elderly Medicare patients' claims data. STUDY DESIGN: Using a sample of survey respondent/beneficiary dyads stratified by physician specialty, we estimated cross-sectional regressions of annual costs on patient covariates and a medical malpractice fear index formed from five validated physician survey questions...
January 26, 2017: Health Services Research
https://www.readbyqxmd.com/read/28124443/an-ethnographic-study-of-health-information-technology-use-in-three-intensive-care-units
#20
Myles Leslie, Elise Paradis, Michael A Gropper, Simon Kitto, Scott Reeves, Peter Pronovost
OBJECTIVES: To identify the impact of a full suite of health information technology (HIT) on the relationships that support safety and quality among intensive care unit (ICU) clinicians. DATA SOURCES: A year-long comparative ethnographic study of three academic ICUs was carried out. A total of 446 hours of observational data was collected in the form of field notes. A subset of these observations-134 hours-was devoted to job-shadowing individual clinicians and conducting a time study of their HIT usage...
January 25, 2017: Health Services Research
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