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Health Services Research

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https://www.readbyqxmd.com/read/29790166/physical-therapy-as-the-first-point-of-care-to-treat-low-back-pain-an-instrumental-variables-approach-to-estimate-impact-on-opioid-prescription-health-care-utilization-and-costs
#1
Bianca K Frogner, Kenneth Harwood, C Holly A Andrilla, Malaika Schwartz, Jesse M Pines
OBJECTIVE: To compare differences in opioid prescription, health care utilization, and costs among patients with low back pain (LBP) who saw a physical therapist (PT) at the first point of care, at any time during the episode or not at all. DATA SOURCES: Commercial health insurance claims data, 2009-2013. STUDY DESIGN: Retrospective analyses using two-stage residual inclusion instrumental variable models to estimate rates for opioid prescriptions, imaging services, emergency department visits, hospitalization, and health care costs...
May 23, 2018: Health Services Research
https://www.readbyqxmd.com/read/29790162/getting-what-we-pay-for-how-do-risk-based-payments-to-medicare-advantage-plans-compare-with-alternative-measures-of-beneficiary-health-risk
#2
Paul D Jacobs, Richard Kronick
OBJECTIVE: To estimate the relative health risk of Medicare Advantage (MA) beneficiaries compared to those in Traditional Medicare (TM). DATA SOURCES/STUDY SETTING: Medicare claims and enrollment records for the sample of beneficiaries enrolled in Part D between 2008 and 2015. STUDY DESIGN: We assigned therapeutic classes to Medicare beneficiaries based on their prescription drug utilization. We then regressed nondrug health spending for TM beneficiaries in 2015 on demographic and therapeutic class identifiers for 2014 and used coefficients from this regression to predict relative risk of both MA and TM beneficiaries...
May 22, 2018: Health Services Research
https://www.readbyqxmd.com/read/29777535/the-relationship-between-costs-and-quality-in-veterans-health-administration-community-living-centers-an-analysis-using-longitudinal-data
#3
James F Burgess, Michael Shwartz, Kelly Stolzmann, Jennifer L Sullivan
OBJECTIVE: To examine the relationship between cost and quality in Veterans Health Administration (VA) nursing homes (called Community Living Centers, CLCs) using longitudinal data. DATA SOURCES/STUDY SETTING: One hundred and thirty CLCs over 13 quarters (from FY2009 to FY2012) were studied. Costs, resident days, and resident severity (RUGs score) were obtained from the VA Managerial Cost Accounting System. Clinical quality measures were obtained from the Minimum Data Set, and resident-centered care (RCC) was measured using the Artifacts of Culture Change Tool...
May 18, 2018: Health Services Research
https://www.readbyqxmd.com/read/29774534/adverse-selection-into-and-within-the-individual-health-insurance-market-in-california-in-2014
#4
Vicki Fung, Cassandra G K Peitzman, Julie Shi, Catherine Y Liang, William H Dow, Alan M Zaslavsky, Bruce H Fireman, Stephen F Derose, Michael E Chernew, Joseph P Newhouse, John Hsu
OBJECTIVE: The Affordable Care Act (ACA) introduced reforms to mitigate adverse selection into and within the individual insurance market. We examined the traits and predicted medical spending of enrollees in California post-ACA. DATA SOURCES: Survey of 2,103 enrollees in individual market plans, on- and off-exchange, in 2014. STUDY DESIGN: We compared actual versus potential participants using data from the 2014 California Health Interview Survey on respondents who were individually insured or uninsured...
May 17, 2018: Health Services Research
https://www.readbyqxmd.com/read/29770445/cost-effectiveness-of-a-community-based-diabetes-prevention-program-with-participation-incentives-for-medicaid-beneficiaries
#5
Todd Gilmer, Patrick J O'Connor, Jeffrey S Schiff, Gretchen Taylor, Gabriela Vazquez-Benitez, Joyce E Garrett, Houa Vue-Her, Sarah Rinn, Julie Anderson, Jay Desai
OBJECTIVE: To examine the cost-effectiveness of a community-based Diabetes Prevention Program (DPP) for Medicaid beneficiaries from the perspective of the health care sector. DATA SOURCES/STUDY SETTING: A total of 847 Medicaid enrollees at high risk for type 2 diabetes participating in a community-based DPP. STUDY DESIGN: Pre- and post clinical outcome and cost data were used as inputs into a validated diabetes simulation model. The model was used to evaluate quality-adjusted life years (QALYs) and health care costs over a 40-year time horizon from the perspective of the health care sector...
May 16, 2018: Health Services Research
https://www.readbyqxmd.com/read/29770443/the-impact-of-policy-incentives-on-long-term-care-insurance-and-medicaid-costs-does-underwriting-matter
#6
Portia Y Cornell, David C Grabwoski
OBJECTIVE: To test whether underwriting modifies the effect of state-based incentives on individuals' purchase of long-term care insurance. DATA SOURCE: Health and Retirement Study (HRS), 1996-2012. STUDY DESIGN: We estimated difference-in-difference regression models with an interaction of state policy indicators with individuals' probabilities of being approved for long-term care insurance. DATA EXTRACTION: We imputed probabilities of underwriting approval for respondents in the HRS using a model developed with underwriting decisions from two U...
May 16, 2018: Health Services Research
https://www.readbyqxmd.com/read/29770438/health-insurance-and-poverty-in-trajectories-of-out-of-pocket-expenditure-among-low-income-middle-aged-adults
#7
Eunsun Kwon, Sojung Park, Timothy D McBride
OBJECTIVE: To assess the effects of longitudinal patterns of health insurance and poverty on out-of-pocket expenditures among low-income late middle-aged adults. DATA SOURCES/STUDY SETTING: Six waves (2002-2012) of the Health and Retirement Study, in combination with RAND Center for the Study of Aging data, were used. STUDY DESIGN: A random coefficient regression analysis was conducted in a multilevel growth curve framework to estimate the impact of health insurance and poverty on out-of-pocket expenditures...
May 16, 2018: Health Services Research
https://www.readbyqxmd.com/read/29766499/optimal-timing-of-physician-visits-after-hospital-discharge-to-reduce-readmission
#8
Bruno D Riverin, Erin C Strumpf, Ashley I Naimi, Patricia Li
OBJECTIVE: To identify the optimal timing of in-person physician visit after hospital discharge to yield the largest reduction in readmission among elderly or chronically ill patients. DATA SOURCES/STUDY SETTING/EXTRACTION METHODS: We extracted insurance billing data on 620,656 admissions for any cause from 2002 to 2009 in Quebec, Canada. STUDY DESIGN: We used flexible survival models to estimate inverse probability weights for the precise timing (days) of in-person physician visit after discharge and weighted competing risk outcome models...
May 15, 2018: Health Services Research
https://www.readbyqxmd.com/read/29756355/development-and-validation-of-a-high-quality-composite-real-world-mortality-endpoint
#9
Melissa D Curtis, Sandra D Griffith, Melisa Tucker, Michael D Taylor, William B Capra, Gillis Carrigan, Ben Holzman, Aracelis Z Torres, Paul You, Brandon Arnieri, Amy P Abernethy
OBJECTIVE: To create a high-quality electronic health record (EHR)-derived mortality dataset for retrospective and prospective real-world evidence generation. DATA SOURCES/STUDY SETTING: Oncology EHR data, supplemented with external commercial and US Social Security Death Index data, benchmarked to the National Death Index (NDI). STUDY DESIGN: We developed a recent, linkable, high-quality mortality variable amalgamated from multiple data sources to supplement EHR data, benchmarked against the highest completeness U...
May 14, 2018: Health Services Research
https://www.readbyqxmd.com/read/29740818/bringing-invisible-partners-in-care-out-of-the-shadows-employment-effects-of-informal-care-provision-in-europe-and-implications-for-the-united-states
#10
EDITORIAL
Courtney Harold Van Houtven
No abstract text is available yet for this article.
May 8, 2018: Health Services Research
https://www.readbyqxmd.com/read/29740816/the-impact-of-the-hospital-readmissions-reduction-program-across-insurance-types-in-california
#11
David S Zingmond, Li-Jung Liang, Punam Parikh, José J Escarce
OBJECTIVE: Examine 30-day readmission rates for indicator conditions before and after adoption of the Hospital Readmissions Reduction Program (HRRP). DATA: California hospital discharge data, 2005 to 2014. STUDY DESIGN: Estimated difference between pre-HRRP trends and post-HRRP rates of hospital readmissions after hospitalization for indicator conditions targeted by the HRRP (heart attack, heart failure, and pneumonia) by payer among insured adults...
May 8, 2018: Health Services Research
https://www.readbyqxmd.com/read/29740810/development-of-a-caregiver-reported-experience-measure-for-pediatric-hospital-to-home-transitions
#12
Arti D Desai, Elizabeth A Jacob-Files, Sarah J Lowry, Douglas J Opel, Rita Mangione-Smith, Maria T Britto, Waylon J Howard
OBJECTIVE: To develop and test a caregiver-reported experience measure for pediatric hospital-to-home transitions. DATA SOURCES/STUDY SETTING: Primary data were collected between 07/2014 and 05/2015 from caregivers within 2-8 weeks of their child's discharge from a tertiary care children's hospital. STUDY DESIGN/DATA COLLECTION: We used a step-wise approach to developing the measure that included drafting de novo survey items based on caregiver interviews (n = 18), pretesting items using cognitive interviews (n = 18), and pilot testing revised items among an independent sample of caregivers (n = 500)...
May 8, 2018: Health Services Research
https://www.readbyqxmd.com/read/29740807/the-mental-health-parity-and-addiction-equity-act-evaluation-study-impact-on-nonquantitative-treatment-limits-for-specialty-behavioral-health-care
#13
Amber Gayle Thalmayer, Jessica M Harwood, Sarah Friedman, Francisca Azocar, L Amy Watson, Haiyong Xu, Susan L Ettner
OBJECTIVE: To assess frequency, type, and extent of behavioral health (BH) nonquantitative treatment limits (NQTLs) before and after implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). DATA SOURCES: Secondary administrative data for Optum carve-out and carve-in plans. STUDY DESIGN: Cross-tabulations and "two-part" regression models were estimated to assess associations of parity period with NQTLs...
May 8, 2018: Health Services Research
https://www.readbyqxmd.com/read/29736944/the-impact-of-dementia-special-care-units-on-quality-of-care-an-instrumental-variables-analysis
#14
Nina R Joyce, Thomas G McGuire, Stephen J Bartels, Susan L Mitchell, David C Grabowski
OBJECTIVE: To compare the quality of care following admission to a nursing home (NH) with and without a dementia special care unit (SCU) for residents with dementia. DATA SOURCES/STUDY SETTING: National resident-level minimum dataset assessments (MDS) 2005-2010 merged with Medicare claims and provider-level data from the Online Survey, Certification, and Reporting database. STUDY DESIGN: We employ an instrumental variable approach to address the endogeneity of selection into an SCU facility controlling for a range of individual-level covariates...
May 7, 2018: Health Services Research
https://www.readbyqxmd.com/read/29736940/growing-reinsurance-payments-weaken-competitive-bidding-in-medicare-part-d
#15
Jeah Jung, Roger Feldman
OBJECTIVES: To examine variation in risk-adjusted reinsurance payments across Part D plans, analyze its implications for the program, and explore options to reduce reinsurance payments. DATA/STUDY DESIGN: 2007-2015 Part D Plan Payment and Premium data; 2010-2013 Part D Prescription Drug Event data; and 2013 Part D Plan Formulary Files. PRINCIPAL FINDINGS: Risk-adjusted reinsurance payments varied widely across plans at a given out-of-pocket (OOP) premium...
May 7, 2018: Health Services Research
https://www.readbyqxmd.com/read/29722010/the-rewards-and-challenges-of-writing-for-a-mass-media-audience
#16
EDITORIAL
Austin B Frakt, Aaron E Carroll, Harold A Pollack, Keith Humphreys
No abstract text is available yet for this article.
May 2, 2018: Health Services Research
https://www.readbyqxmd.com/read/29667171/mental-health-service-utilization-before-and-after-receipt-of-a-service-connected-disability-award-for-ptsd-findings-from-a-national-sample
#17
Rebecca K Sripada, Claire M Hannemann, Paula P Schnurr, Brian P Marx, Stacey J Pollack, John F McCarthy
OBJECTIVE: To determine patterns of mental health service use before and after VA disability compensation awards for posttraumatic stress disorder (PTSD). DATA SOURCES: A 10 percent random sample of VHA-enrolled Veterans with new or increased PTSD service connection between 2012 and 2014 (n = 22,249). STUDY DESIGN: We used latent trajectory analysis to identify utilization patterns and multinomial logistic regression to assess associations between Veteran characteristics and trajectory membership...
April 17, 2018: Health Services Research
https://www.readbyqxmd.com/read/29665053/the-determinants-of-the-technical-efficiency-of-acute-inpatient-care-in-canada
#18
Li Wang, Michel Grignon, Sheril Perry, Xi-Kuan Chen, Alison Ytsma, Sara Allin, Katerina Gapanenko
OBJECTIVE: To evaluate the technical efficiency of acute inpatient care at the pan-Canadian level and to explore the factors associated with inefficiency-why hospitals are not on their production frontier. DATA SOURCES/STUDY SETTING: Canadian Management Information System (MIS) database (CMDB) and Discharge Abstract Database (DAD) for the fiscal year of 2012-2013. STUDY DESIGN: We use a nonparametric approach (data envelopment analysis) applied to three peer groups (teaching, large, and medium hospitals, focusing on their acute inpatient care only)...
April 17, 2018: Health Services Research
https://www.readbyqxmd.com/read/29659010/helping-consumers-make-high-value-health-care-choices-the-devil-is-in-the-details
#19
EDITORIAL
Jeffrey T Kullgren
No abstract text is available yet for this article.
April 16, 2018: Health Services Research
https://www.readbyqxmd.com/read/29658993/does-the-primary-care-behavioral-health-model-reduce-emergency-department-visits
#20
Neftali Serrano, Ronald Prince, Meghan Fondow, Kenneth Kushner
OBJECTIVE: To examine the impact of integrating behavioral health services using the primary care behavioral health (PCBH) model on emergency department (ED) utilization. DATA SOURCES: Utilization data from three Dane County, Wisconsin hospitals and four primary care clinics from 2003 to 2011. STUDY DESIGN: We used a retrospective, quasi-experimental, controlled, pre-post study design. Starting in 2007, two clinics began integrating behavioral health into their primary care practices with a third starting in 2010...
April 16, 2018: Health Services Research
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