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Health Services Research

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https://www.readbyqxmd.com/read/29143331/implicit-review-instrument-to-evaluate-quality-of-care-delivered-by-physicians-to-children-in-emergency-departments
#1
James P Marcin, Patrick S Romano, Madan Dharmar, James M Chamberlain, Nanette Dudley, Charles G Macias, Lise E Nigrovic, Elizabeth C Powell, Alexander J Rogers, Meridith Sonnett, Leah Tzimenatos, Elizabeth R Alpern, Rebecca Andrews-Dickert, Dominic A Borgialli, Erika Sidney, Charlie Casper, Jonathan Michael Dean, Nathan Kuppermann
OBJECTIVE: To evaluate the consistency, reliability, and validity of an implicit review instrument that measures the quality of care provided to children in the emergency department (ED). DATA SOURCES/STUDY SETTING: Medical records of randomly selected children from 12 EDs in the Pediatric Emergency Care Applied Research Network (PECARN). STUDY DESIGN: Eight pediatric emergency medicine physicians applied the instrument to 620 medical records...
November 16, 2017: Health Services Research
https://www.readbyqxmd.com/read/29143325/physician-practice-transitions-to-system-ownership-do-not-result-in-diminished-practice-responsiveness-to-patients
#2
Bing Ying Poon, Stephen Shortell, Hector P Rodriguez
OBJECTIVE: To examine the extent to which physician-to-system ownership transitions are associated with declines in practice-reported patient responsiveness (PRPR). DATA SOURCES: A longitudinal cohort of practices (n = 897) from the National Survey of Large Physician Organizations/National Survey of Small- and Medium-Sized Physician Organizations (2006/08) and the National Survey of All-Size Physician Organizations (2012/13). STUDY DESIGN: Multivariable regression estimated the effect of ownership on changes in PRPR, controlling for practice size, specialty composition, other practice, and market characteristics...
November 16, 2017: Health Services Research
https://www.readbyqxmd.com/read/29143323/regarding-implicit-review-instrument-to-evaluate-quality-of-care-delivered-by-physicians-to-children-in-emergency-departments
#3
EDITORIAL
Scott A Lorch
No abstract text is available yet for this article.
November 16, 2017: Health Services Research
https://www.readbyqxmd.com/read/29134632/heterogeneous-relationships-between-labor-income-and-health-by-race-ethnicity
#4
Abdulkarim M Meraya, Nilanjana Dwibedi, Kim Innes, Sophie Mitra, Xi Tan, Usha Sambamoorthi
OBJECTIVE: To examine the race-stratified relationships between labor income and health among working-age adults in the United States. DATA SOURCES: Data from eight waves of the Panel Study of Income Dynamics from 1999 through 2013 were used for this study. STUDY DESIGN: The study utilized a retrospective observational longitudinal design with repeated measures of labor income and health measures. System-generalized method of moment and heteroscedasticity-based instrument regressions were used to examine the relationships between labor income and physical and mental health measures, respectively...
November 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/29134630/successful-community-discharge-following-postacute-rehabilitation-for-medicare-beneficiaries-analysis-of-a-patient-centered-quality-measure
#5
Michael P Cary, Janet Prvu Bettger, Jessica M Jarvis, Kenneth J Ottenbacher, James E Graham
OBJECTIVE: To determine the sociodemographic and clinical characteristics as well as health services use associated with successful community discharge. DATA SOURCE: Inpatient Rehabilitation Facility-Patient Assessment Instrument and Medicare Provider Analysis and Review files. STUDY DESIGN: We retrospectively examined 167,664 Medicare beneficiaries discharged from inpatient rehabilitation facilities (IRFs) in 2013 to determine the sociodemographic and clinical characteristics as well as health services use associated with successful community discharge...
November 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/29131324/advanced-imaging-reduces-cost-compared-to-standard-of-care-in-emergency-department-of-triage-of-acute-chest-pain
#6
Pamela S Noack, Jhanna A Moore, Michael Poon
OBJECTIVE: To evaluate medical costs of novel therapies in complex medical settings using registry data. DATA SOURCE/STUDY SETTING: Primary data, from 2008 to 2010. We used patient registry data to evaluate cost and quality performance of coronary computed tomography angiography (CCTA) in triaging chest pain patients in our tertiary care emergency department and to model financial performance under Medicare's two midnight rule. STUDY DESIGN: Using generalized linear modeling, we retrospectively compared estimated expenditures for evaluation of low-to-intermediate-risk chest pain for demographic and medically risk matched samples of 894 patients each, triaged with CCTA or local standard of care (SOC) using Medicare reimbursement as a proxy...
November 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/29131339/geographic-disparities-in-access-to-nursing-home-services-assessing-fiscal-stress-and-quality-of-care
#7
Young Joo Park, Erika G Martin
OBJECTIVE: We test whether nursing homes serving predominately low-income and racial minority residents (compositional explanation) or located in neighborhoods with higher concentrations of low-income and racial minority residents (contextual explanation) have worse financial outcomes and care quality. DATA SOURCES: Healthcare Cost Report Information System, Nursing Home Compare, Online Survey Certification and Reporting Certification, and American Community Survey...
November 12, 2017: Health Services Research
https://www.readbyqxmd.com/read/29131330/shifting-patterns-in-cesarean-delivery-scheduling-and-timing-in-oregon-before-and-after-a-statewide-hard-stop-policy
#8
Ifeoma Muoto, Blair G Darney, Bernard Lau, Yvonne W Cheng, Mark W Tomlinson, Duncan R Neilson, Steven A Friedman, Joanne Rogovoy, Aaron B Caughey, Jonathan M Snowden
OBJECTIVES: To assess the use and timing of scheduled cesareans and other categories of cesarean delivery and the prevalence of neonatal morbidity among cesareans in Oregon before and after the implementation of Oregon's statewide policy limiting elective early deliveries. DATA SOURCES: Oregon vital statistics records, 2008-2013. STUDY DESIGN: Retrospective cohort study, with multivariable logistic regression, regression controlling for time trends, and interrupted time series analyses, to compare the odds of different categories of cesarean delivery and the odds of neonatal morbidity pre- and postpolicy...
November 12, 2017: Health Services Research
https://www.readbyqxmd.com/read/29058316/does-enrollment-in-high-deductible-health-plans-encourage-price-shopping
#9
Xinke Zhang, Amelia Haviland, Ateev Mehrotra, Peter Huckfeldt, Zachary Wagner, Neeraj Sood
OBJECTIVE: To investigate whether enrollment in high-deductible health plans (HDHPs) led enrollees to choose lower-priced providers for office visits and laboratory tests. STUDY SETTING: Claims data from more than 40 large employers. STUDY DESIGN: We compared the change in price for office visits and laboratory tests for enrollees who switched to HDHPs versus enrollees who remained in traditional plans. We estimated separate models for enrollees who changed providers versus those who remained with the same provider to disentangle the effects of HDHPs on provider choice and negotiated prices...
October 23, 2017: Health Services Research
https://www.readbyqxmd.com/read/29053183/impact-of-recent-medicaid-expansions-on-office-based-primary-care-and-specialty-care-among-the-newly-eligible
#10
Adam I Biener, Samuel H Zuvekas, Steven C Hill
OBJECTIVE: To quantify the effect of Medicaid expansions on office-based care among the newly eligible. DATA SOURCE: 2008-2014 Medical Expenditure Panel Survey. STUDY DESIGN: The main sample is adults age 26-64 with incomes ≤138% of poverty who were not eligible for Medicaid prior to the Affordable Care Act. For this population, difference-in-differences linear probability models compare utilization between expansion and nonexpansion states and between 2008-2013 and 2014...
October 20, 2017: Health Services Research
https://www.readbyqxmd.com/read/29053179/providing-family-planning-services-at-primary-care-organizations-after-the-exclusion-of-planned-parenthood-from-publicly-funded-programs-in-texas-early-qualitative-evidence
#11
Kari White, Kristine Hopkins, Daniel Grossman, Joseph E Potter
OBJECTIVE: To explore organizations' experiences providing family planning during the first year of an expanded primary care program in Texas. DATA SOURCES: Between November 2014 and February 2015, in-depth interviews were conducted with program administrators at 30 organizations: 7 women's health organizations, 13 established primary care contractors (e.g., community health centers, public health departments), and 10 new primary care contractors. STUDY DESIGN: Interviews addressed organizational capacities to expand family planning and integrate services with primary care...
October 20, 2017: Health Services Research
https://www.readbyqxmd.com/read/29047143/rising-drug-costs-drives-the-growth-of-pharmacy-benefit-managers-exclusion-lists-are-exclusion-decisions-value-based
#12
Joshua P Cohen, Christelle El Khoury, Christopher-Paul Milne, Sandra M Peters
OBJECTIVE: We examine whether drugs' excluded versus recommended status on pharmacy benefit manager exclusion lists corresponds to evidence from cost-effectiveness analyses, lack of evidence, or rebates. DATA SOURCES: To find cost-effectiveness data for drugs on 2016 exclusion lists of CVS Caremark and Express Scripts, we searched the Tufts Cost-Effectiveness Analysis Registry and the peer-reviewed literature. STUDY DESIGN: For each excluded and recommended drug, we compared the mean cost-per-QALY, and we calculated the difference between the numbers of excluded and recommended drugs for which we could find no cost-effectiveness evidence...
October 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/29047118/modeling-community-discharge-of-medicaid-nursing-home-residents-implications-for-money-follows-the-person
#13
Zachary Hass, Mark Woodhouse, Robert Kane, Greg Arling
OBJECTIVE: To build and test a model that predicts community discharge probabilities for Medicaid-eligible nursing home (NH) residents who remain in the nursing home at 90 days after admission and, thus, would be candidates for the Money Follows the Person (MFP) program. DATA SOURCE: The Minimum Data Set, Medicaid Management Information Systems, and Minnesota Vital Statistics file. DATA: Cohort of 33, 590 nursing home stays that qualified for Medicaid by the 90th day of their stay from 383 Minnesota nursing homes from July 2011 to June 2013...
October 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/29044547/effects-of-early-dual-eligible-special-needs-plans-on-health-expenditure
#14
Yongkang Zhang, Mark L Diana
OBJECTIVE: To examine the effects of the penetration of dual-eligible special needs plans (D-SNPs) on health care spending. DATA SOURCES/STUDY SETTING: Secondary state-level panel data from Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) public use file and Special Needs Plan Comprehensive Reports, Area Health Resource Files, and Medicaid Managed Care Enrollment Report between 2007 and 2011. STUDY DESIGN: A difference-in-difference strategy that adjusts for dual-eligibles' demographic and socioeconomic characteristics, state health resources, beneficiaries' health risk factors, Medicare/Medicaid enrollment, and state- and year-fixed effects...
October 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28994109/the-hospital-still-the-doctors-workplace-s-a-cautionary-note-for-approaches-to-safety-and-value-improvement
#15
EDITORIAL
Laurence F McMahon, Joel D Howell
No abstract text is available yet for this article.
October 9, 2017: Health Services Research
https://www.readbyqxmd.com/read/28994106/safety-culture-and-mortality-after-acute-myocardial-infarction-a-study-of-medicare-beneficiaries-at-171-hospitals
#16
David M Shahian, Xiu Liu, Laura P Rossi, Elizabeth A Mort, Sharon-Lise T Normand
OBJECTIVES: To investigate the association between hospital safety culture and 30-day risk-adjusted mortality for Medicare patients with acute myocardial infarction (AMI) in a large, diverse hospital cohort. SUBJECTS: The final analytic cohort consisted of 19,357 Medicare AMI discharges (MedPAR data) linked to 257 AHRQ Hospital Survey on Patient Safety Culture surveys from 171 hospitals between 2008 and 2013. STUDY DESIGN: Observational, cross-sectional study using hierarchical logistic models to estimate the association between hospital safety scores and 30-day risk-adjusted patient mortality...
October 9, 2017: Health Services Research
https://www.readbyqxmd.com/read/28967677/the-association-of-health-reform-and-infant-health-evidence-from-massachusetts
#17
Michel H Boudreaux, Rada K Dagher, Scott A Lorch
OBJECTIVE: To estimate whether the incidence of low birthweight and rates of infant mortality were associated with Massachusetts health reform in the overall population and for subgroups that are at higher risk for poor health outcomes. DATA SOURCES: Individual-level data on birthweight were obtained from the National Center for Health Statistics detailed natality files, and aggregated county-level mortality rates were generated from linked birth-death files. We used restricted versions of each file that had intact state and substate geographic identifiers...
October 2, 2017: Health Services Research
https://www.readbyqxmd.com/read/28944955/trends-in-use-of-risk-reducing-mastectomy-in-a-context-of-celebrity-decisions-and-media-coverage-an-observational-study-in-the-united-states-and-australia
#18
Jialin Mao, Louisa Jorm, Art Sedrakyan
OBJECTIVE: To examine trends in risk-reducing mastectomy (RRM) and immediate breast reconstruction in New York State and New South Wales, especially before and after Angelina Jolie's announcement of her surgery in 2013. DATA SOURCE: Hospital discharge data, 2004-2014. STUDY DESIGN: Trends in procedures were assessed using Poisson regression and the Cochrane-Armitage test. DATA EXTRACTION METHODS: Extracted using procedure codes...
September 25, 2017: Health Services Research
https://www.readbyqxmd.com/read/28940236/using-weighted-hospital-service-area-networks-to-explore-variation-in-preventable-hospitalization
#19
Michael O Falster, Louisa R Jorm, Alastair H Leyland
OBJECTIVE: To demonstrate the use of multiple-membership multilevel models, which analytically structure patients in a weighted network of hospitals, for exploring between-hospital variation in preventable hospitalizations. DATA SOURCES: Cohort of 267,014 people aged over 45 in NSW, Australia. STUDY DESIGN: Patterns of patient flow were used to create weighted hospital service area networks (weighted-HSANs) to 79 large public hospitals of admission...
September 22, 2017: Health Services Research
https://www.readbyqxmd.com/read/28940537/spending-per-medicare-beneficiary-is-higher-in-hospital-owned-small-and-medium-sized-physician-practices
#20
Michael F Pesko, Andrew M Ryan, Stephen M Shortell, Kennon R Copeland, Patricia P Ramsay, Xuming Sun, Jayme L Mendelsohn, Diane R Rittenhouse, Lawrence P Casalino
OBJECTIVE: To examine the relationship of physician versus hospital ownership of small- and medium-sized practices with spending and utilization of care. DATA SOURCE/STUDY SETTING/DATA COLLECTION: Survey data for 1,045 primary care-based practices of 1-19 physicians linked to Medicare claims data for 2008 for 282,372 beneficiaries attributed to the 3,010 physicians in these practices. STUDY DESIGN: We used generalized linear models to estimate the associations between practice characteristics and outcomes (emergency department visits, index admissions, readmissions, and spending)...
September 21, 2017: Health Services Research
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