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Health Services Research

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
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
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
Lawrence C Pellegrini, Kimberley H Geissler
OBJECTIVE: To examine the relationship between Social Security Disability Insurance (SSDI) enrollment and health care employment. DATA SOURCES: State-year level data from government and other publicly available sources for all states (2000-2014). STUDY DESIGN: Population-weighted linear regression analyses model associations between each health care employment measure and each SSDI enrollment measure (i.e., SSDI overall, physical, or mental health enrollment rates), controlling for factors associated with health care employment, state fixed effects, and secular time trends...
September 21, 2017: Health Services Research
Jacqueline Nwando Olayiwola, Margae Knox, Kate Dubé, Emily Chen-Yuan Lu, Tem Woldeyesus, Iguehi E James, Rachel Willard-Grace, Delphine Tuot
OBJECTIVE: To understand patient, primary care clinician (PCC), and subspecialist perspectives on potential, unexplored roles for patients in electronic consultation and referral (eCR) systems. DATA SOURCES: Primary focus group and survey data collected April-November 2015. Zuckerberg San Francisco General Hospital (ZSFG) is part of an integrated public health delivery system. Its mature eCR system was first implemented in 2005. STUDY DESIGN: This mixed-methods study synthesizes patient, subspecialist, and PCC perspectives through two patient focus groups in English, Spanish, and Cantonese (n = 6); subspecialist focus groups (n = 2); and an electronic survey of all PCCs (n = 222/634, 35 percent response)...
September 20, 2017: Health Services Research
Amanda L Brewster, Marie A Brault, Annabel X Tan, Leslie A Curry, Elizabeth H Bradley
OBJECTIVE: To understand how health care providers and social services providers coordinate their work in communities that achieve relatively low health care utilization and costs for older adults. STUDY SETTING: Sixteen Hospital Service Areas (HSAs) in the United States. STUDY DESIGN: We conducted a qualitative study of HSAs with performance in the top or bottom quartiles nationally across three key outcomes: ambulatory care sensitive hospitalizations, all-cause risk-standardized readmission rates, and average reimbursements per Medicare beneficiary...
September 19, 2017: Health Services Research
Mauro Laudicella, Stephen Martin, Paolo Li Donni, Peter C Smith
OBJECTIVES: To measure the impact of the improvement in hospital survival rates on patients' subsequent utilization of unplanned (emergency) admissions. DATA SOURCES/STUDY SETTING: Unplanned admissions occurring in all acute hospitals of the National Health Service in England between 2000 and 2009, including 286,027 hip fractures, 375,880 AMI, 387,761 strokes, and 9,966,246 any cause admissions. STUDY DESIGN: Population-based retrospective cohort study...
September 14, 2017: Health Services Research
Eileen T Lake, Douglas Staiger, Erika Miles Edwards, Jessica G Smith, Jeannette A Rogowski
OBJECTIVES: To describe the variation across neonatal intensive care units (NICUs) in missed nursing care in disproportionately black and non-black-serving hospitals. To analyze the nursing factors associated with missing nursing care. DATA SOURCES/STUDY SETTING: Survey of random samples of licensed nurses in four large U.S. states. STUDY DESIGN: This was a retrospective, secondary analysis of 1,037 staff nurses in 134 NICUs classified into three groups based on their percent of infants of black race...
September 14, 2017: Health Services Research
Fasiha Kanwal, Jeffrey M Pyne, Shahriar Tavakoli-Tabasi, Susan Nicholson, Brian Dieckgraefe, Erma Storay, Matthew Bidwell Goetz, Jennifer R Kramer, Donna Smith, Shubhada Sansgiry, Aylin Tansel, Allen L Gifford, Steven M Asch
OBJECTIVE: To test the effectiveness of a collaborative depression care model in improving depression and hepatitis C virus (HCV) care. DATA SOURCES/STUDY SETTING: Hepatitis C virus clinic patients who screened positive for depression at four Veterans Affairs Hospitals. STUDY DESIGN: We compared off-site depression collaborative care (delivered by depression care manager, pharmacist, and psychiatrist) with usual care in a randomized trial...
September 11, 2017: Health Services Research
Katherine Baicker, Heidi L Allen, Bill J Wright, Sarah L Taubman, Amy N Finkelstein
OBJECTIVE: To evaluate the effect of Medicaid coverage on dental care outcomes, a major health concern for low-income populations. DATA SOURCES: Primary and secondary data on health care use and outcomes for participants in Oregon's 2008 Medicaid lottery. STUDY DESIGN: We used the lottery's random selection to gauge the causal effects of Medicaid on dental care needs, medication, and emergency department visits for dental care. DATA COLLECTION: Data were collected for lottery participants over 2 years, including mail surveys (N = 23,777) and in-person questionnaires (N = 12,229)...
September 8, 2017: Health Services Research
Harold S Luft
No abstract text is available yet for this article.
September 4, 2017: Health Services Research
Corinna Hentschker, Roman Mennicken
OBJECTIVE: To examine the causal effect of a hospital's experience with treating hip fractures (volume) on patient treatment outcomes. DATA SOURCES: We use a full sample of administrative data from German hospitals for 2007. The data provide detailed information on patients and hospitals. We also reference the hospitals' addresses and the zip codes of patients' place of residence. STUDY DESIGN: We apply an instrumental variable approach to address endogeneity concerns due to reverse causality and unobserved patient heterogeneity...
September 4, 2017: Health Services Research
Winston Liaw, Anuradha Jetty, Stephen Petterson, Andrew Bazemore, Larry Green
OBJECTIVE: (1) To examine usual source of care (USC) trends across four categories (No USC, Person USC, Person, in Facility USC, and Facility USC), and (2) to determine whether USC types are associated with emergency department (ED) visits and hospital admissions. DATA SOURCE: 1996-2014 Medical Expenditure Panel Surveys. STUDY DESIGN: We stratified each USC category, by age, region, gender, poverty, insurance, race/ethnicity, and education and used regression to determine the characteristics associated with USC types, ED visits, and hospital admissions...
August 31, 2017: Health Services Research
Aileen B Chen, Ling Li, Angel M Cronin, Gabriel A Brooks, Brian D Kavanagh, Deborah Schrag
OBJECTIVE: To compare alternative strategies for specifying cancer-free control cohorts for estimating cancer-attributable costs of care. DATA SOURCE, STUDY DESIGN, DATA EXTRACTION: Secondary data analysis of Surveillance, Epidemiology, and End Results data linked to Medicare claims among patients diagnosed with colorectal, lung, breast, and prostate cancers, 2007-2011. We estimated cancer-attributable costs using three alternative reference cohorts: (1) noncancer Medicare patients individually matched by demographic characteristics, (2) noncancer patients individually matched on demographic factors and comorbidity score, (3) cancer patients as their own control, using prediagnosis costs...
August 31, 2017: Health Services Research
Samuel D Towne, Kayla Fair, Matthew Lee Smith, Diane M Dowdy, SangNam Ahn, Obioma Nwaiwu, Marcia G Ory
OBJECTIVE: We examined multilevel factors associated with hospital discharge status among older adults suffering a fall-related hospitalization. DATA SOURCES: The 2011-2013 (n = 131,978) Texas Inpatient Hospital Discharge Public-Use File was used. STUDY DESIGN/METHODS: Multilevel logistic regression analyses estimated the likelihood of being discharged to institutional settings versus home. PRINCIPAL FINDINGS: Factors associated with a greater likelihood of being discharged to institutional settings versus home/self-care included being female, white, older, having greater risk of mortality, receiving care in a non-teaching hospital, having Medicare (versus Private) coverage, and being admitted from a non-health care facility (versus clinical referral)...
August 31, 2017: Health Services Research
Jasmine L Travers, Andrew W Dick, Patricia W Stone
OBJECTIVE/STUDY QUESTION: To examine racial/ethnic differences in influenza and pneumococcal vaccination receipt and nonreceipt among nursing home (NH) residents post implementation of federal vaccination policy. DATA SOURCES/STUDY SETTING/STUDY DESIGN/DATA COLLECTION/EXTRACTION METHODS: An analysis of a merged national cross-sectional dataset containing resident assessment, facility, and community data for years 2010-2013 was conducted. Logistic regressions omitting and including facility fixed effects were used to examine the influence of race and ethnicity (black, Hispanic, white) and black concentration on vaccination status across and within NHs...
August 31, 2017: Health Services Research
Neel M Butala, Eric A Secemsky, Jason H Wasfy, Kevin F Kennedy, Robert W Yeh
OBJECTIVE: To investigate whether hospital readmission after admission for heart failure (HF), myocardial infarction (MI), and pneumonia varies by season. DATA SOURCES: All patients in 2005-2009 Healthcare Cost and Utilization Project State Inpatient Databases for New York and California hospitalized for HF, MI, or pneumonia. STUDY DESIGN: The relationship between discharge season and unplanned readmission within 30 days was evaluated using multivariate modified Poisson regression...
August 31, 2017: Health Services Research
Jeanette W Chung, Karl Y Bilimoria, Jonah J Stulberg, Christopher M Quinn, Larry V Hedges
OBJECTIVE/STUDY QUESTION: To estimate and compare sample average treatment effects (SATE) and population average treatment effects (PATE) of a resident duty hour policy change on patient and resident outcomes using data from the Flexibility in Duty Hour Requirements for Surgical Trainees Trial ("FIRST Trial"). DATA SOURCES/STUDY SETTING: Secondary data from the National Surgical Quality Improvement Program and the FIRST Trial (2014-2015). STUDY DESIGN: The FIRST Trial was a cluster-randomized pragmatic noninferiority trial designed to evaluate the effects of a resident work hour policy change to permit greater flexibility in scheduling on patient and resident outcomes...
August 21, 2017: Health Services Research
Eva-Maria Oppel, Gary J Young
OBJECTIVE: To examine the relationship between nurse staffing patterns and patients' experience of care in hospitals with a particular focus on staffing flexibility. DATA SOURCES/STUDY SETTING: The study sample comprised U.S. general hospitals between 2010 and 2012. Nurse staffing data came from the American Hospital Association Annual Survey, and patient experience data came from the Medicare Hospital Consumer Assessment of Healthcare Providers and Systems. STUDY DESIGN: An observational research design was used entailing a pooled, cross-sectional data set...
August 14, 2017: Health Services Research
Seung Ju Kim, Kyu-Tae Han, Woorim Kim, Sun Jung Kim, Eun-Cheol Park
OBJECTIVE: To explore the impact of mandatory adoption of diagnosis-related groups (DRGs) on the use of outpatient care in Korea. DATA SOURCES: National Health Claim data from 2,022 hospitals and 1,029,101 admission cases during 2011-2014: tonsillectomy/adenoidectomy, inguinal/femoral hernia operation, and hemorrhoidectomy. STUDY DESIGN: Outcome variables included probability of outpatient visit, number of outpatient visits, and outpatient medical expenditures within 30 days...
August 14, 2017: Health Services Research
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