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Health Services Research

Katie N Dainty, M Bianca Seaton, Ian R Drennan, Laurie J Morrison
OBJECTIVE: Community paramedicine (CP) is a model of community-based health care being used around the world. Our objective was to study the patient perspective and valuation of this type of program to understand its potential value for primary care innovation in the future. STUDY SETTING: The EPIC community paramedicine program is a partnership between primary care physicians and specially trained community paramedics, designed to provide in-home support for complex chronic disease patients in Ontario, Canada...
March 15, 2018: Health Services Research
Jonathan M Snowden, Ifeoma Muoto
No abstract text is available yet for this article.
March 13, 2018: Health Services Research
James F Burgess, Nir Menachemi, Matthew L Maciejewski
OBJECTIVE: To present revised core competencies for doctoral programs in health services research (HSR), modalities to deliver these competencies, and suggested methods for assessing mastery of these competencies. DATA SOURCES AND DATA COLLECTION: Core competencies were originally developed in 2005, updated (but unpublished) in 2008, modestly updated for a 2016 HSR workforce conference, and revised based on feedback from attendees. Additional feedback was obtained from doctoral program directors, employer/workforce experts and attendees of presentation on these competencies at the AcademyHealth's June 2017 Annual Research Meeting...
March 13, 2018: Health Services Research
Sungwoo Lim, Tejinder P Singh, Gerod Hall, Sarah Walters, L Hannah Gould
OBJECTIVE: To assess the impact of a New York City supportive housing program on housing stability and preventable emergency department (ED) visits/hospitalizations among heads of homeless families with mental and physical health conditions or substance use disorders. DATA SOURCES: Multiple administrative data from New York City and New York State for 966 heads of families eligible for the program during 2007-12. STUDY DESIGN: We captured housing events and health care service utilization during 2 years prior to the first program eligibility date (baseline) and 2 years postbaseline...
March 12, 2018: Health Services Research
Sarah Axeen
OBJECTIVE: To determine characteristics and trends in opioid use, questionable use, and prescribing in Medicare. STUDY SETTING: Opioid prescriptions filled through Medicare Part D for beneficiaries with full-year, fee-for-service Medicare coverage during 2006 to 2012. STUDY DESIGN: Retrospective analysis of a 20 percent sample of Medicare claims data. Estimates are adjusted using multivariable regression analysis. DATA COLLECTION: Opioid use, opioid abuse, questionable opioid use, and opioid prescribing by specialty...
March 12, 2018: Health Services Research
David W Bates, Lipika Samal
No abstract text is available yet for this article.
March 11, 2018: Health Services Research
Sherri Rose
OBJECTIVE: To propose nonparametric double robust machine learning in variable importance analyses of medical conditions for health spending. DATA SOURCES: 2011-2012 Truven MarketScan database. STUDY DESIGN: I evaluate how much more, on average, commercially insured enrollees with each of 26 of the most prevalent medical conditions cost per year after controlling for demographics and other medical conditions. This is accomplished within the nonparametric targeted learning framework, which incorporates ensemble machine learning...
March 11, 2018: Health Services Research
Stephen Bornstein, Melissa Heritage, Amanda Chudak, Robyn Tamblyn, Meghan McMahon, Adalsteinn Brown
OBJECTIVE: To develop an enriched set of core competencies for health services and policy research (HSPR) doctoral training that will help graduates maximize their impact across a range of academic and nonacademic work environments and roles. DATA SOURCES/STUDY SETTING: Data were obtained from multiple sources, including literature reviews, key informant interviews, stakeholder consultations, and Expert Working Group (EWG) meetings between January 2015 and March 2016...
March 11, 2018: Health Services Research
Jordan E Rullo, Jilian L Foxen, Joan M Griffin, Jennifer R Geske, Cesar A Gonzalez, Stephanie S Faubion, Michelle van Ryn
OBJECTIVES: To (1) test whether patient attitudes toward intake forms at three Midwestern outpatient clinics are significantly more negative among those who are asked to complete SOGI questions versus those who are not; and (2) gain an in-depth understanding of patient concerns about SOGI questions. STUDY SETTING: Data were collected between 6/29/2015 and 2/29/2016 from new patients (N = 491) who presented at three outpatient clinics in a large academic medical center...
March 9, 2018: Health Services Research
Margaret E Kruk, Anna D Gage, Godfrey M Mbaruku, Hannah H Leslie
OBJECTIVE: Describe content of clinical care for sick children in low-resource settings. DATA SOURCES: Nationally representative health facility surveys in Haiti, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Tanzania, and Uganda from 2007 to 2015. STUDY DESIGN: Clinical visits by sick children under 5 years were observed and caregivers interviewed. We describe duration and content of the care in the visit and estimate associations between increased content and caregiver knowledge and satisfaction...
March 7, 2018: Health Services Research
Laura M Keohane, Robert J Gambrel, Salama S Freed, David Stevenson, Melinda B Buntin
OBJECTIVES: To analyze the sources of per-beneficiary Medicare spending growth between 2007 and 2014, including the role of demographic characteristics, attributes of Medicare coverage, and chronic conditions. DATA SOURCES: Individual-level Medicare spending and enrollment data. STUDY DESIGN: Using an Oaxaca-Blinder decomposition model, we analyzed whether changes in price-standardized, per-beneficiary Medicare Part A and B spending reflected changes in the composition of the Medicare population or changes in relative spending levels per person...
March 6, 2018: Health Services Research
Vincent Mor, Paul Wallace
No abstract text is available yet for this article.
March 6, 2018: Health Services Research
Sunny C Lin, Jordan Everson, Julia Adler-Milstein
OBJECTIVE: To assess whether the level of health information exchange (HIE) in U.S. hospitals is related to technology capabilities, incentives to exchange, or both. STUDY SETTING: A total of 1,812 hospitals attesting to stage 2 of Medicare's Meaningful Use Incentive Program through April 2016. STUDY DESIGN: Hospital-level, multivariate OLS regression with state fixed effects was used to analyze the relationship between technology capability and incentives measures, and percent of care transitions with summary of care records (SCRs) sent electronically to subsequent providers...
February 28, 2018: Health Services Research
Katherine A Ornstein, Melissa M Garrido, Albert L Siu, Evan Bollens-Lund, Kenneth M Langa, Amy S Kelley
OBJECTIVE: To examine how patients' location of death relates to health care utilization and spending for surviving spouses. DATA SOURCES/STUDY SETTING: Health and Retirement Study (HRS) 2000-2012 linked to the Dartmouth Atlas and Medicare claims data. STUDY DESIGN: This was an observational study. We matched bereaved spouses whose spouses died in a hospital to those whose spouses died outside the hospital using propensity scores based on decedent and spouse demographic and clinical characteristics, care preferences, and regional practice patterns...
February 28, 2018: Health Services Research
Corey J Hayes, Xiaocong Li, Chenghui Li, Anuj Shah, Niranjan Kathe, Naleen Raj Bhandari, Nalin Payakachat
OBJECTIVE: Evaluate the association between opioid therapy and health-related quality of life (HRQoL) in participants with chronic, noncancer pain (CNCP). DATA SOURCES: Medical Expenditure Panel Survey Longitudinal, Medical Conditions, and Prescription Files. STUDY DESIGN: Using a retrospective cohort study design, the Mental Health Component (MCS12) and Physical Health Component (PCS12) scores of the Short Form-12 Version 2 were assessed to measure mental and physical HRQoL...
February 25, 2018: Health Services Research
Jessica Greene, Rebecca M Sacks
OBJECTIVE: To identify approaches to presenting cost and resource use measures that support consumers in selecting high-value hospitals. DATA SOURCES: Survey data were collected from U.S. employees of Analog Devices (n = 420). STUDY DESIGN: In two online experiments, participants viewed comparative data on four hospitals. In one experiment, participants were randomized to view one of five versions of the same comparative cost data, and in the other experiment they viewed different versions of the same readmissions data...
February 25, 2018: Health Services Research
Ingo W K Kolodziej, Arndt R Reichert, Hendrik Schmitz
OBJECTIVE: To estimate how labor force participation is affected when adult children provide informal care to their parents. DATA SOURCE: Survey of Health, Ageing and Retirement in Europe from 2004 to 2013. STUDY DESIGN: To offset the problem of endogeneity, we exploit the availability of other potential caregivers within the family as predictors of the probability to provide care for a dependent parent. Contrary to most previous studies, the dataset covers the whole working-age population in the majority of European countries...
February 22, 2018: Health Services Research
Kevin F Erickson, Yuanchao Zheng, Vivian Ho, Wolfgang C Winkelmayer, Jay Bhattacharya, Glenn M Chertow
OBJECTIVE: To examine whether market competition is associated with improved health outcomes in hemodialysis. DATA SOURCES: Secondary analysis of data from a national dialysis registry between 2001 and 2011. STUDY DESIGN: We conducted one- and two-part linear regression models, using each hospital service area (HSA) as its own control, to examine the independent associations among market concentration and health outcomes. DATA COLLECTION: We selected cohorts of patients receiving in-center hemodialysis in the United States at the start of each calendar year...
February 22, 2018: Health Services Research
Dahai Yue, Petra W Rasmussen, Ninez A Ponce
OBJECTIVE: To assess racial/ethnic differential impacts of the ACA's Medicaid expansion on low-income, nonelderly adults' access to primary care. DATA SOURCES: Behavioral Risk Factor Surveillance System, State Physicians Workforce Data Book, and Bureau of Labor Statistics, in 2013 and 2015. STUDY DESIGN: Quasi-experimental design with difference-in-differences analyses. Outcomes included health insurance coverage, having personal doctor(s), being unable to see doctors because of cost, and receiving a flu shot...
February 22, 2018: Health Services Research
Yuting Zhang, Seo Hyon Baik, Samuel H Zuvekas
OBJECTIVE: To examine variations in premium and cost-sharing across marketplace plans available to eligible families. DATA SOURCES: 2011-2012 Medical Expenditure Panel Survey (MEPS), 2014 health plan data from, and the 2011 Medicare Part D public formulary file. STUDY DESIGN: We identified a nationally representative cohort of individuals in the MEPS who would have been eligible for marketplace coverage. For each family, we simulated the total out-of-pocket payment (premium plus cost-sharing) under each available plan in their county of residence, assuming their premarketplace use...
February 14, 2018: Health Services Research
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