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Health Services Research

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https://www.readbyqxmd.com/read/28523674/massachusetts-health-reform-s-effect-on-hospitalizations-with-substance-use-disorder-related-diagnoses
#1
Karen E Lasser, Amresh D Hanchate, Danny McCormick, Alexander Y Walley, Richard Saitz, Meng-Yun Lin, Nancy R Kressin
OBJECTIVE: To examine whether Massachusetts (MA) health reform affected substance (alcohol or drug) use disorder (SUD)-related hospitalizations in acute care hospitals. DATA/STUDY SETTING: 2004-2010 MA inpatient discharge data. DESIGN: Difference-in-differences analysis to identify pre- to postreform changes in age- and sex-standardized population-based rates of SUD-related medical and surgical hospitalizations, adjusting for secular trends...
May 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28517042/the-impact-of-the-aca-medicaid-expansions-on-health-insurance-coverage-through-2015-and-coverage-disparities-by-age-race-ethnicity-and-gender
#2
George L Wehby, Wei Lyu
OBJECTIVE: Examine the ACA Medicaid expansion effects on Medicaid take-up and private coverage through 2015 and coverage disparities by age, race/ethnicity, and gender. DATA SOURCES: 2011-2015 American Community Survey for 3,137,989 low-educated adults aged 19-64 years. STUDY DESIGN: Difference-in-differences regressions accounting for national coverage trends and state fixed effects. PRINCIPAL FINDINGS: Expansion effects doubled in 2015 among low-educated adults, with a nearly 8 percentage-point increase in Medicaid take-up and 6 percentage-point decline in uninsured rate...
May 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28516496/the-impact-of-childhood-obesity-on-health-and-health-service-use
#3
Jonas Minet Kinge, Stephen Morris
OBJECTIVE: To test the impact of obesity on health and health care use in children, by the use of various methods to account for reverse causality and omitted variables. DATA SOURCES/STUDY SETTING: Fifteen rounds of the Health Survey for England (1998-2013), which is representative of children and adolescents in England. STUDY DESIGN: We use three methods to account for reverse causality and omitted variables in the relationship between BMI and health/health service use: regression with individual, parent, and household control variables; sibling fixed effects; and instrumental variables based on genetic variation in weight...
May 17, 2017: Health Services Research
https://www.readbyqxmd.com/read/28493481/hospital-and-health-insurance-markets-concentration-and-inpatient-hospital-transaction-prices-in-the-u-s-health-care-market
#4
Seidu Dauda
OBJECTIVE: To examine the effects of hospital and insurer markets concentration on transaction prices for inpatient hospital services. DATA SOURCES: Measures of hospital and insurer markets concentration derived from American Hospital Association and HealthLeaders-InterStudy data are linked to 2005-2008 inpatient administrative data from Truven Health MarketScan Databases. STUDY DESIGN: Uses a reduced-form price equation, controlling for cost and demand shifters and accounting for possible endogeneity of market concentration using instrumental variables (IV) technique...
May 11, 2017: Health Services Research
https://www.readbyqxmd.com/read/28480598/further-evidence-on-the-system-wide-effects-of-the-hospital-readmissions-reduction-program
#5
Berna Demiralp, Fang He, Lane Koenig
OBJECTIVE: To investigate the potential spillover effects of the Hospital Readmissions Reduction Program (HRRP) on readmissions for nontargeted conditions and patient populations. We examine HRRP effects on nontargeted conditions separately and on non-Medicare populations in Florida and California. DATA SOURCES: From 2007-2013, 100 percent Medicare inpatient claims data, 2007-2013 State Inpatient Database (SID) for Florida, and 2007-2011 SID for California. STUDY DESIGN: We conducted an interrupted time series analysis to estimate the change in 30-day all-cause unplanned readmission trends after the start of HRRP using logistic regression...
May 8, 2017: Health Services Research
https://www.readbyqxmd.com/read/28480593/the-aca-medicaid-expansion-disproportionate-share-hospitals-and-uncompensated-care
#6
Susan Camilleri
OBJECTIVE: To estimate the effect of the first full year of the ACA Medicaid expansion on hospital provision of uncompensated care, with special attention paid to hospitals that treat a disproportionate share of low-income patients. DATA SOURCES: Data from a balanced panel of short-term, general, nonfederal, Medicare-certified hospitals were obtained from Medicare cost reports from 2011 to 2014. STUDY DESIGN/STUDY SETTING: A series of difference-in-differences analyses were performed using hospitals in nonexpansion states as the control group...
May 8, 2017: Health Services Research
https://www.readbyqxmd.com/read/28480588/racial-ethnic-and-gender-disparities-in-health-care-use-and-access
#7
Jennifer I Manuel
OBJECTIVE: To document racial/ethnic and gender differences in health service use and access after the Affordable Care Act went into effect. DATA SOURCE: Secondary data from the 2006-2014 National Health Interview Survey. STUDY DESIGN: Linear probability models were used to estimate changes in health service use and access (i.e., unmet medical need) in two separate analyses using data from 2006 to 2014 and 2012 to 2014. DATA EXTRACTION: Adult respondents aged 18 years and older (N = 257,560)...
May 8, 2017: Health Services Research
https://www.readbyqxmd.com/read/28474736/effect-of-out-of-pocket-cost-on-medication-initiation-adherence-and-persistence-among-patients-with-type-2-diabetes-the-diabetes-study-of-northern-california-distance
#8
Andrew J Karter, Melissa M Parker, Matthew D Solomon, Courtney R Lyles, Alyce S Adams, Howard H Moffet, Mary E Reed
OBJECTIVE: To estimate the effect of out-of-pocket (OOP) cost on nonadherence to classes of cardiometabolic medications among patients with diabetes. DATA SOURCES/SETTING: Electronic health records from a large, health care delivery system for 223,730 patients with diabetes prescribed 842,899 new cardiometabolic medications during 2006-2012. STUDY DESIGN: Observational, new prescription cohort study of the effect of OOP cost on medication initiation and adherence...
May 5, 2017: Health Services Research
https://www.readbyqxmd.com/read/28474359/the-hcup-sid-imputation-project-improving-statistical-inferences-for-health-disparities-research-by-imputing-missing-race-data
#9
Yan Ma, Wei Zhang, Stephen Lyman, Yihe Huang
OBJECTIVE: To identify the most appropriate imputation method for missing data in the HCUP State Inpatient Databases (SID) and assess the impact of different missing data methods on racial disparities research. DATA SOURCES/STUDY SETTING: HCUP SID. STUDY DESIGN: A novel simulation study compared four imputation methods (random draw, hot deck, joint multiple imputation [MI], conditional MI) for missing values for multiple variables, including race, gender, admission source, median household income, and total charges...
May 4, 2017: Health Services Research
https://www.readbyqxmd.com/read/28474343/repeated-close-physician-coronary-artery-bypass-grafting-teams-associated-with-greater-teamwork
#10
Jordan Everson, Russell J Funk, Samuel R Kaufman, Jason Owen-Smith, Brahmajee K Nallamothu, Francis D Pagani, John M Hollingsworth
OBJECTIVE: To determine whether observed patterns of physician interaction around shared patients are associated with higher levels of teamwork as perceived by physicians. DATA SOURCES/STUDY SETTING: Michigan Medicare beneficiaries who underwent coronary artery bypass grafting (CABG) procedures at 24 hospitals in the state between 2008 and 2011. STUDY DESIGN: We assessed hospital teamwork using the teamwork climate scale in the Safety Attitudes Questionnaire...
May 4, 2017: Health Services Research
https://www.readbyqxmd.com/read/28439903/did-health-care-reform-help-kentucky-address-disparities-in-coverage-and-access-to-care-among-the-poor
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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