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Health Services Research

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https://www.readbyqxmd.com/read/28439903/did-health-care-reform-help-kentucky-address-disparities-in-coverage-and-access-to-care-among-the-poor
#1
Joseph A Benitez, E Kathleen Adams, Eric E Seiber
OBJECTIVE: To evaluate the impact of Kentucky's full rollout of the Affordable Care Act on disparities in access to care due to poverty. DATA SOURCE: Restricted version of the Behavioral Risk Factor Surveillance System (BRFSS) for Kentucky and years 2011-2015. STUDY DESIGN: We use a difference-in-differences framework to compare trends before and after implementation of the Affordable Care Act (ACA) in health insurance coverage, several access measures, and health care utilization for residents in higher versus lower poverty ZIP codes...
April 25, 2017: Health Services Research
https://www.readbyqxmd.com/read/28419487/the-effect-of-medicaid-physician-fee-increases-on-health-care-access-utilization-and-expenditures
#2
Kevin Callison, Binh T Nguyen
OBJECTIVE: To evaluate the effect of Medicaid fee changes on health care access, utilization, and spending for Medicaid beneficiaries. DATA SOURCE: We use the 2008 and 2012 waves of the Medical Expenditure Panel Survey linked to state-level Medicaid-to-Medicare primary care reimbursement ratios obtained through surveys conducted by the Urban Institute. We also incorporate data from the Current Population Survey and the Area Resource Files. STUDY DESIGN: Using a control group made up of the low-income privately insured, we conduct a difference-in-differences analysis to assess the relationship between Medicaid fee changes and access to care, utilization of health care services, and out-of-pocket medical expenditures for Medicaid enrollees...
April 16, 2017: Health Services Research
https://www.readbyqxmd.com/read/28419451/do-state-continuing-medical-education-requirements-for-physicians-improve-clinical-knowledge
#3
Jonathan L Vandergrift, Bradley M Gray, Weifeng Weng
OBJECTIVE: To evaluate the effect of state continuing medical education (CME) requirements on physician clinical knowledge. DATA SOURCES: Secondary data for 19,563 general internists who took the Internal Medicine Maintenance of Certification (MOC) examination between 2006 and 2013. STUDY DESIGN: We took advantage of a natural experiment resulting from variations in CME requirements across states over time and applied a difference-in-differences methodology to measure associations between changes in CME requirements and physician clinical knowledge...
April 16, 2017: Health Services Research
https://www.readbyqxmd.com/read/28397261/validity-and-reliability-of-administrative-coded-data-for-the-identification-of-hospital-acquired-infections-an-updated-systematic-review-with-meta-analysis-and-meta-regression-analysis
#4
Olga Redondo-González, José María Tenías, Ángel Arias, Alfredo J Lucendo
OBJECTIVE: To conduct an updated assessment of the validity and reliability of administrative coded data (ACD) in identifying hospital-acquired infections (HAIs). METHODS: We systematically searched three libraries for studies on ACD detecting HAIs compared to manual chart review. Meta-analyses were conducted for prosthetic and nonprosthetic surgical site infections (SSIs), Clostridium difficile infections (CDIs), ventilator-associated pneumonias/events (VAPs/VAEs) and non-VAPs/VAEs, catheter-associated urinary tract infections (CAUTIs), and central venous catheter-related bloodstream infections (CLABSIs)...
April 11, 2017: Health Services Research
https://www.readbyqxmd.com/read/28384376/a-two-step-method-to-identify-positive-deviant-physician-organizations-of-accountable-care-organizations-with-robust-performance-management-systems
#5
Alexander F Pimperl, Hector P Rodriguez, Julie A Schmittdiel, Stephen M Shortell
OBJECTIVE: To identify positive deviant (PD) physician organizations of Accountable Care Organizations (ACOs) with robust performance management systems (PMSYS). DATA SOURCE: Third National Survey of Physician Organizations (NSPO3, n = 1,398). STUDY DESIGN: Organizational and external factors from NSPO3 were analyzed. DATA COLLECTION/EXTRACTION METHODS: Linear regression estimated the association of internal and contextual factors on PMSYS...
April 6, 2017: Health Services Research
https://www.readbyqxmd.com/read/28378322/disparities-in-potentially-preventable-hospitalizations-near-national-estimates-for-hispanics
#6
Chen Feng, Michael K Paasche-Orlow, Nancy R Kressin, Jennifer E Rosen, Lenny López, Eun Ji Kim, Meng-Yun Lin, Amresh D Hanchate
OBJECTIVE: To obtain near-national rates of potentially preventable hospitalization (PPH)-a marker of barriers to outpatient care access-for Hispanics; to examine their differences from other race-ethnic groups and by Hispanic national origin; and to identify key mediating factors. DATA SOURCES/STUDY SETTING: Data from all-payer inpatient discharge databases for 15 states accounting for 85 percent of Hispanics nationally. STUDY DESIGN: Combining counts of inpatient discharges with census population for adults aged 18 and older, we estimated age-sex-adjusted PPH rates...
April 4, 2017: Health Services Research
https://www.readbyqxmd.com/read/28376563/the-effect-of-access-to-electronic-health-records-on-throughput-efficiency-and-imaging-utilization-in-the-emergency-department
#7
Matthew M Knepper, Edward M Castillo, Theodore C Chan, David A Guss
STUDY OBJECTIVE: To evaluate whether the availability of Electronic Health Records (EHRs) reduces throughput time and utilization of advanced imaging for patients in an academic ED. DATA SOURCES: All patients arriving at an academic Emergency Department (ED) via ambulance between June 1, 2011, and June 4, 2012, were included in the study. This accounted for 9,970 unique ambulance patient visits. STUDY DESIGN: Retrospective noninterventional analysis of patients in an academic ED...
April 4, 2017: Health Services Research
https://www.readbyqxmd.com/read/28369814/development-and-validation-of-the-agency-for-healthcare-research-and-quality-measures-of-potentially-preventable-emergency-department-ed-visits-the-ed-prevention-quality%C3%A2-indicators-for-general-health-conditions
#8
Sheryl Davies, Ellen Schultz, Maria Raven, Nancy Ewen Wang, Carol L Stocks, Mucio Kit Delgado, Kathryn M McDonald
OBJECTIVE: To develop and validate rates of potentially preventable emergency department (ED) visits as indicators of community health. DATA SOURCES: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project 2008-2010 State Inpatient Databases and State Emergency Department Databases. STUDY DESIGN: Empirical analyses and structured panel reviews. METHODS: Panels of 14-17 clinicians and end users evaluated a set of ED Prevention Quality Indicators (PQIs) using a Modified Delphi process...
March 30, 2017: Health Services Research
https://www.readbyqxmd.com/read/28369871/emergency-department-attendance-after-telephone-triage-a-population-based-data-linkage-study
#9
Amy Gibson, Deborah Randall, Duong T Tran, Mary Byrne, Anthony Lawler, Alys Havard, Maureen Robinson, Louisa R Jorm
OBJECTIVE: To investigate compliance with telephone helpline advice to attend an emergency department (ED) and the acuity of patients who presented to ED following a call. DATA SOURCES/COLLECTION METHODS: In New South Wales (NSW), Australia, 2009-2012, all (1.04 million) calls to a telephone triage service, ED presentations, hospital admissions and death registrations, linked using probabilistic data linkage. STUDY DESIGN: Population-based, observational cohort study measuring ED presentations within 24 hours of a call in patients (1) with dispositions to attend ED (compliance) and (2) low-urgency dispositions (self-referral), triage categories on ED presentation...
March 29, 2017: Health Services Research
https://www.readbyqxmd.com/read/28369887/a-longitudinal-assessment-of-the-effect-of-resident-centered-care-on-quality-in%C3%A2-veterans-health-administration-community-living-centers
#10
Jennifer L Sullivan, Michael Shwartz, Kelly Stolzmann, Melissa K Afable, James F Burgess
OBJECTIVE: To examine whether changes in resident-centered care (RCC) over time were associated with changes in quality. DATA SOURCES/STUDY SETTING: Data sources were the Minimum Dataset quality indicators (which consist of measures of both prevalence and incidence of adverse events) and the Artifacts of Culture Change Tool (which measures RCC; FYs 2009-2012) from 130 Veterans Health Administration community living centers. STUDY DESIGN: A retrospective longitudinal study...
March 28, 2017: Health Services Research
https://www.readbyqxmd.com/read/28369885/medicare-s-acute-care-episode-demonstration-effects-of-bundled-payments-on-costs-and-quality-of-surgical-care
#11
Lena M Chen, Andrew M Ryan, Terry Shih, Jyothi R Thumma, Justin B Dimick
OBJECTIVE: To evaluate whether participation in Medicare's Acute Care Episode (ACE) Demonstration Program-an early, small, voluntary episode-based payment program-was associated with a change in expenditures or quality of care. DATA SOURCES/STUDY SETTING: Medicare claims for patients who underwent cardiac or orthopedic surgery from 2007 to 2012 at ACE or control hospitals. STUDY DESIGN: We used a difference-in-differences approach, matching on baseline and pre-enrollment volume, risk-adjusted Medicare payments, and clinical outcomes to identify controls...
March 28, 2017: Health Services Research
https://www.readbyqxmd.com/read/28345256/physician-competition-in-the-era-of-accountable-care-organizations
#12
Michael R Richards, Catherine T Smith, Amy J Graves, Melinda B Buntin, Matthew J Resnick
OBJECTIVE: To calculate physician concentration levels for all U.S. markets using detailed data on integration and accountable care organization (ACO) participation. DATA SOURCE: 2015 SK&A office-based physician survey linked to all commercial and public payer ACOs. STUDY DESIGN: We construct three separate Herfindahl-Hirschman Index (HHI) measures and plot their distributions. We then investigate how prevailing levels of concentration change when incorporating more detailed organizational features into the HHI measure...
March 27, 2017: Health Services Research
https://www.readbyqxmd.com/read/28345210/geographic-disparities-in-availability-of-opioid-use-disorder-treatment-for-medicaid-enrollees
#13
Amanda J Abraham, Christina M Andrews, Marissa E Yingling, Jerry Shannon
OBJECTIVE: To examine county-level geographic variation in treatment admissions among opioid treatment programs (OTPs) that accept Medicaid in the continental United States. DATA SOURCES/STUDY SETTING: Data come from the 2012 National Survey of Substance Abuse Treatment Services. STUDY DESIGN/DATA COLLECTION: We used local measures of spatial autocorrelation (LISA) analysis to identify (1) clusters of counties with higher and lower than average rates of opioid use disorders and (2) clusters of counties with higher and lower than average treatment admissions among OTPs that accept Medicaid, adjusting for county population size...
March 27, 2017: Health Services Research
https://www.readbyqxmd.com/read/28345144/adapting-evaluations-of-alternative-payment-models-to-a-changing-environment
#14
Thomas W Grannemann, Randall S Brown
OBJECTIVE: To identify the most robust methods for evaluating alternative payment models (APMs) in the emerging health care delivery system environment. STUDY DESIGN (APPROACH): We assess the impact of widespread testing of alternative payment models on the ability to find credible comparison groups. We consider the applicability of factorial research designs for assessing the effects of these models. PRINCIPAL FINDINGS: The widespread adoption of alternative payment models could effectively eliminate the possibility of comparing APM results with a "pure" control or comparison group unaffected by other interventions...
March 27, 2017: Health Services Research
https://www.readbyqxmd.com/read/28332190/impact-of-disease-prevalence-adjustment-on-hospitalization-rates-for%C3%A2-chronic-ambulatory-care-sensitive-conditions-in-germany
#15
Johannes Pollmanns, Patrick S Romano, Maria Weyermann, Max Geraedts, Saskia E Drösler
OBJECTIVES: To explore effects of disease prevalence adjustment on ambulatory care-sensitive hospitalization (ACSH) rates used for quality comparisons. DATA SOURCES/STUDY SETTING: County-level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative ambulatory diagnosis data were used. STUDY DESIGN: A retrospective cross-sectional study using in- and outpatient secondary data was performed...
March 22, 2017: Health Services Research
https://www.readbyqxmd.com/read/28294328/the-longitudinal-association-between-psychological-factors-and-health-care-use
#16
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
#17
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
#18
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
#19
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
#20
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
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