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Health Services Research

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https://www.readbyqxmd.com/read/28105730/geography-not-health-system-affiliations-determines-patients-revisits-to-the-emergency-department
#1
Kristin L Rising, David N Karp, Rhea E Powell, Timothy W Victor, Brendan G Carr
OBJECTIVES: To determine how frequently patients revisit the emergency department after an initial encounter, and to describe revisit capture rates for the same hospital, health system, and geographic region. DATA SOURCES/STUDY SETTING: Florida state data from January 1, 2010, to June 30, 2011, from the Healthcare Cost and Utilization Project. STUDY DESIGN: This is a retrospective cohort study of emergency department return visits among Florida adults over an 18-month period...
January 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28105639/persistent-variation-in-medicare-payment-authorization-for-home-hemodialysis-treatments
#2
Adam S Wilk, Richard A Hirth, Wei Zhang, John R C Wheeler, Marc N Turenne, Tammie A Nahra, Kathryn K Sleeman, Joseph M Messana
OBJECTIVE: To analyze variation in medical care use attributable to Medicare's decentralized claims adjudication process as exemplified in home hemodialysis (HHD) therapy. DATA SOURCES/STUDY SETTING: Secondary data analysis using 2009-2012 paid Medicare claims for HHD and in-center hemodialysis (IHD). STUDY DESIGN: We compared variation across Medicare administrative contractors (MACs) in predicted paid treatments per standardized patient-month for HHD and IHD patients...
January 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28101955/prescription-drug-monitoring-programs-produce-a-limited-impact-on-painkiller-prescribing-in-medicare-part-d
#3
Courtney R Yarbrough
OBJECTIVE: To measure the impact of prescription drug monitoring programs (PDMPs) on prescribing of opioid and nonopioid painkillers. DATA SOURCE: 2010-2013 physician-level Medicare Part D prescribing data released by the Centers for Medicare and Medicaid Services and Propublica. STUDY DESIGN: Using difference-in-differences models with physician-level fixed effects, the study compares prescribing in states with and without PDMPs for opioid and nonopioid analgesics, oxycodone, hydrocodone, and opioids by controlled substances Schedules II-IV...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28097657/public-trust-in-health-information-sharing-a-measure-of-system-trust
#4
Jodyn E Platt, Peter D Jacobson, Sharon L R Kardia
OBJECTIVE: To measure public trust in a health information sharing in a broadly defined health system (system trust), inclusive of health care, public health, and research; to identify individual characteristics that predict system trust; and to consider these findings in the context of national health initiatives (e.g., learning health systems and precision medicine) that will expand the scope of data sharing. DATA SOURCES: Survey data (n = 1,011) were collected in February 2014...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28097649/hospital-variation-in-utilization-of-life-sustaining-treatments-among-patients-with-do-not-resuscitate-orders
#5
Allan J Walkey, Janice Weinberg, Renda Soylemez Wiener, Colin R Cooke, Peter K Lindenauer
OBJECTIVE: To determine between-hospital variation in interventions provided to patients with do not resuscitate (DNR) orders. DATA SOURCES/SETTING: United States Agency of Healthcare Research and Quality, Healthcare Cost and Utilization Project, California State Inpatient Database. STUDY DESIGN: Retrospective cohort study including hospitalized patients aged 40 and older with potential indications for invasive treatments: in-hospital cardiac arrest (indication for CPR), acute respiratory failure (mechanical ventilation), acute renal failure (hemodialysis), septic shock (central venous catheterization), and palliative care...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28093724/the-potential-of-high-dimensional-propensity-scores-in-health-services-research-an-exemplary-study-on-the-quality-of-care-for-elective-percutaneous-coronary-interventions
#6
Dirk Enders, Christoph Ohlmeier, Edeltraut Garbe
OBJECTIVE: Evaluating the potential of the high-dimensional propensity score (HDPS) to control for residual confounding in studies analyzing quality of care based on administrative health insurance data. DATA SOURCE: Secondary data from 2004 to 2009 from three German statutory health insurance providers. STUDY DESIGN: We conducted a retrospective cohort study in patients with elective percutaneous coronary interventions (PCIs) and compared the mortality risk between the in- and outpatient setting using Cox regression...
January 16, 2017: Health Services Research
https://www.readbyqxmd.com/read/28083879/health-services-utilization-in-older-adults-with-dementia-receiving-care%C3%A2-coordination-the-mind-at-home-trial
#7
Halima Amjad, Stephanie K Wong, David L Roth, Jin Huang, Amber Willink, Betty S Black, Deirdre Johnston, Peter V Rabins, Laura N Gitlin, Constantine G Lyketsos, Quincy M Samus
OBJECTIVE: To investigate effects of a novel dementia care coordination program on health services utilization. DATA SOURCES/STUDY SETTING: A total of 303 community-dwelling adults aged ≥70 with a cognitive disorder in Baltimore, Maryland (2008-2011). STUDY DESIGN: Single-blind RCT evaluating efficacy of an 18-month care coordination intervention delivered through community-based nonclinical care coordinators, supported by an interdisciplinary clinical team...
January 12, 2017: Health Services Research
https://www.readbyqxmd.com/read/28074495/comparison-of-medicaid-payments-relative-to-medicare-using-inpatient-acute-care-claims-from-the-medicaid-program-fiscal-year-2010-fiscal-year-2011
#8
Devin A Stone, Bridget A Dickensheets, John A Poisal
OBJECTIVE: To compare Medicaid fee-for-service (FFS) inpatient hospital payments to expected Medicare payments. DATA SOURCES: Medicaid and Medicare claims data, Medicare's MS-DRG grouper and inpatient prospective payment system pricer (IPPS pricer). STUDY DESIGN: Medicaid FFS inpatient hospital claims were run through Medicare's MS-DRG grouper and IPPS pricer to compare Medicaid's actual payment against what Medicare would have paid for the same claim...
January 10, 2017: Health Services Research
https://www.readbyqxmd.com/read/28074471/the-probability-of-hospitalizations-for-mild-to-moderate-injuries-by-trauma-center-ownership-type
#9
Etienne E Pracht, Barbara Langland-Orban, Jessica L Ryan
OBJECTIVE: To corroborate anecdotal evidence with systematic evidence of a lower threshold for admission among for-profit hospitals. DATA SOURCES: The study used Florida emergency department and hospital discharge datasets for 2012 to 2014. The treatment variable of interest was for-profit-designated trauma center status. The dependent variable indicated whether a patient with mild-to-moderate injuries was admitted after presenting as a trauma alert and then discharged to home...
January 10, 2017: Health Services Research
https://www.readbyqxmd.com/read/28070913/does-identification-of-previously-undiagnosed-conditions-change-care-seeking-behavior
#10
Rebecca M Myerson, Lisandro D Colantonio, Monika M Safford, Elbert S Huang
OBJECTIVE: To determine whether identification of previously undiagnosed high cholesterol, hypertension, and/or diabetes during an in-home assessment impacts care seeking among Medicare beneficiaries. DATA SOURCES/STUDY SETTING: Data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, which recruited African American and white participants across the continental United States from 2003-2007, were linked to Medicare claims. STUDY DESIGN: We used panel data models to analyze changes in doctor visits for evaluation and management of conditions after participants were assessed, utilizing the study's rolling recruitment to control for secular trends...
January 10, 2017: Health Services Research
https://www.readbyqxmd.com/read/28024315/patient-physician-and-health-system-factors-influencing-the-quality-of-antidepressant-and-sedative-prescribing-for-older-community-dwelling-adults
#11
Rian Marie Extavour, Matthew Perri
OBJECTIVE: To identify determinants of potentially inappropriate (PI) antidepressant and anxiolytic/sedative prescribing for older, community-dwelling adults. DATA SOURCES/STUDY SETTING: Office visits from the 2010 National Ambulatory Medical Care Survey. STUDY DESIGN: A cross-sectional study measuring associations between various patient and physician factors and prescribing of PI antidepressants, and PI sedatives among elderly, using Beers 2012/2015 criteria, a clinical decision model, and multivariate logistic regressions...
December 26, 2016: Health Services Research
https://www.readbyqxmd.com/read/28024314/modeling-health-care-spending-growth-of-older-adults
#12
Laura A Hatfield, Melissa M Favreault, Thomas G McGuire, Michael E Chernew
OBJECTIVE: To forecast out-of-pocket health care spending among older adults. Long-term forecasts allow policy makers to explore potential impacts of policy scenarios, but existing microsimulations do not incorporate details of supplemental insurance coverage and income effects on health care spending. DATA SOURCES: Dynamic microsimulation calibrated to survey and administrative data. STUDY DESIGN: We augment Urban Institute's Dynamic Simulation of Income Model (DYNASIM) with modules that incorporate demand responses and economic equilibria, with dynamics driven by exogenous technological change...
December 26, 2016: Health Services Research
https://www.readbyqxmd.com/read/28024312/factors-that-distinguish-high-performing-accountable-care-organizations-in-the-medicare-shared-savings-program
#13
Thomas D'Aunno, Lauren Broffman, Michael Sparer, Sumit R Kumar
OBJECTIVE: To identify factors that promote the effective performance of accountable care organizations (ACOs) in the Medicare Shared Savings Program. DATA SOURCES/STUDY SETTING: Data come from a convenience sample of 16 Medicare Shared Savings ACOs that were organized around large physician groups. We use claims data from the Center for Medicaid and Medicare Services and data from 60 interviews at three high-performing and three low-performing ACOs. STUDY DESIGN: Explanatory sequential design, using qualitative data to account for patterns observed in quantitative assessment of ACO performance...
December 26, 2016: Health Services Research
https://www.readbyqxmd.com/read/28004385/space-time-cluster-analysis-to-detect-innovative-clinical-practices-a-case-study-of-aripiprazole-in-the-department-of-veterans-affairs
#14
Robert B Penfold, James F Burgess, Austin F Lee, Mingfei Li, Christopher J Miller, Marjorie Nealon Seibert, Todd P Semla, David C Mohr, Lewis E Kazis, Mark S Bauer
OBJECTIVE: To identify space-time clusters of changes in prescribing aripiprazole for bipolar disorder among providers in the VA. DATA SOURCES: VA administrative data from 2002 to 2010 were used to identify prescriptions of aripiprazole for bipolar disorder. Prescriber characteristics were obtained using the Personnel and Accounting Integrated Database. STUDY DESIGN: We conducted a retrospective space-time cluster analysis using the space-time permutation statistic...
December 22, 2016: Health Services Research
https://www.readbyqxmd.com/read/28004380/impact-of-health-system-affiliation-on-hospital-resource-use-intensity-and-quality-of-care
#15
Rachel Mosher Henke, Zeynal Karaca, Brian Moore, Eli Cutler, Hangsheng Liu, William D Marder, Herbert S Wong
OBJECTIVE: To assess the impact of hospital affiliation, centralization, and managed care plan ownership on inpatient cost and quality. DATA SOURCES: Inpatient discharges from 3,957 community hospitals in 44 states and American Hospital Association Annual Survey data from 2010 to 2012. STUDY DESIGN: We conducted a retrospective longitudinal regression analysis using hierarchical modeling of discharges clustered within hospitals. DATA COLLECTION: Detailed discharge data including costs, length of stay, and patient characteristics from the Healthcare Cost and Utilization Project State Inpatient Databases were merged with hospital survey data from the American Hospital Association...
December 22, 2016: Health Services Research
https://www.readbyqxmd.com/read/27981559/relationships-as-medicine-quality-of-the-physician-patient-relationship-determines-physician-influence-on-treatment-recommendation-adherence
#16
Heather Orom, Willie Underwood, Zinan Cheng, D Lynn Homish, I'Yanna Scott
OBJECTIVE: To determine whether quality of physician-patient relationships influences uptake of physician treatment recommendations in men with clinically localized prostate cancer (PCa). STUDY SETTING: Data were collected July 2010 to August 2014 at two cancer centers and three community facilities. STUDY DESIGN: Analyses were prospective and cross-sectional. We modeled associations between quality of the patient-physician relationship and influence of physician recommendations on treatment choice using generalized estimating equations (GEE)...
December 15, 2016: Health Services Research
https://www.readbyqxmd.com/read/27976388/covariate-balancing-through-naturally-occurring-strata
#17
Farrokh Alemi, Amr ElRafey, Ivan Avramovic
OBJECTIVE: To provide an alternative to propensity scoring (PS) for the common situation where there are interacting covariates. SETTING: We used 1.3 million assessments of residents of the United States Veterans Affairs nursing homes, collected from January 1, 2000, through October 9, 2012. DESIGN: In stratified covariate balancing (SCB), data are divided into naturally occurring strata, where each stratum is an observed combination of the covariates...
December 14, 2016: Health Services Research
https://www.readbyqxmd.com/read/27957733/veterans-location-in-health-professional-shortage-areas-implications-for-access-to-care-and-workforce-supply
#18
Jamie Mihoko Doyle, Robin A Streeter
OBJECTIVE: To describe the distribution of Veterans in areas of the United States where there are potentially inadequate supplies of health professionals, and to explore opportunities suggested by this distribution for fostering health workforce flexibility. DATA SOURCES: County-level data from the 2015-2016 Health Resources and Services Administration's (HRSA's) Area Health Resources Files (AHRF) were used to estimate Veteran populations in HRSA-designated health professional shortage areas (HPSAs)...
December 13, 2016: Health Services Research
https://www.readbyqxmd.com/read/27957740/impact-of-enroll-america-on-the-number-of-individuals-covered-through-the-federally-facilitated-marketplace
#19
Sean Orzol, Lauren Hula
OBJECTIVE: To assess the impact of Enroll America's field outreach activities on the number of individuals enrolled in Marketplace coverage during the first open enrollment period. DATA SOURCES/STUDY SETTING: Marketplace enrollment for the initial open enrollment period linked with data on Enroll America's field activities and baseline local-area demographic, economic, and health services characteristics. STUDY DESIGN: We used a quasi-experimental design, comparing Marketplace enrollment during the first open enrollment period in local areas drawn from Enroll America field states to a comparison group of local areas drawn from states that were not served by Enroll America's field effort, but that otherwise match up well with Enroll America states...
December 12, 2016: Health Services Research
https://www.readbyqxmd.com/read/27957734/impact-of-wisconsin-medicaid-policy-change-on-dental-sealant-utilization
#20
Christopher Okunseri, Elaye Okunseri, Raul I Garcia, Cesar Gonzalez, Alexis Visotcky, Aniko Szabo
BACKGROUND: In September 2006, Wisconsin Medicaid changed its policy to allow nondentists to become certified Medicaid providers and to bill for sealants in public health settings. OBJECTIVE: This study examined changes in patterns of dental sealant utilization in first molars of Wisconsin Medicaid enrollees associated with a policy change. DATA SOURCE: The Electronic Data Systems of Medicaid Evaluation and Decision Support for Wisconsin from 2001 to 2009...
December 12, 2016: Health Services Research
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