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Inquiry: a Journal of Medical Care Organization, Provision and Financing

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https://www.readbyqxmd.com/read/28548005/geographic-variation-in-diagnostic-ability-and-quality-of-care-metrics-a-case-study-of-ankylosing-spondylitis-and-low-back-pain
#1
Jason Shafrin, Jenny Griffith, Jin Joo Shim, Caroline Huber, Arijit Ganguli, Wade Aubry
Studies examining geographic variation in care for low back pain often focus on process and outcome measures conditional on patient diagnosis but generally do not take into account a physician's ability to diagnose the root cause of low back pain. In our case study, we used increased detection of ankylosing spondylitis-a relatively rare inflammatory back disease-as a proxy for diagnostic ability and measured the relationship between ankylosing spondylitis detection, potentially inappropriate low back pain care, and cost...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28523946/who-uses-a-price-transparency-tool-implications-for-increasing-consumer-engagement
#2
Rebecca A Gourevitch, Sunita Desai, Andrew L Hicks, Laura A Hatfield, Michael E Chernew, Ateev Mehrotra
Despite the recent proliferation of price transparency tools, consumer use and awareness of these tools is low. Better strategies to increase the use of price transparency tools are needed. To inform such efforts, we studied who is most likely to use a price transparency tool. We conducted a cross-sectional study of use of the Truven Treatment Cost Calculator among employees at 2 large companies for the 12 months following the introduction of the tool in 2011-2012. We examined frequency of sign-ons and used multivariate logistic regression to identify which demographic and health care factors were associated with greater use of the tool...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28494624/an-overview-of-the-performance-improvement-initiatives-by-the-ministry-of-health-in-the-kingdom-of-saudi-arabia
#3
Mazen Hassanain
Saudi Arabia's Ministry of Health (MOH) use corporate performance improvement methodologies to develop and implement performance improvement initiatives designed to continue building on the Ministry's vision of transforming hospital operations and instituting a culture of quality and performance focused on the "patient first" principle. We evaluated the feasibility of setting up a performance improvement unit (PIU) within the MOH to apply the principles of Lean Six Sigma and to change management methodologies...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28486042/cross-cultural-adaptation-and-validation-of-the-attitudes-toward-suicide-questionnaire-among-healthcare-personnel-in-malaysia
#4
Ching Sin Siau, Lei-Hum Wee, Norhayati Ibrahim, Uma Visvalingam, Suzaily Wahab
Understanding attitudes toward suicide, especially among healthcare personnel, is an important step in both suicide prevention and treatment. We document the adaptation process and establish the validity and reliability of the Attitudes Toward Suicide (ATTS) questionnaire among 262 healthcare personnel in 2 major public hospitals in the Klang Valley, Malaysia. The findings indicate that healthcare personnel in Malaysia have unique constructs on suicide attitude, compared with the original study on a Western European sample...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28466658/a-critical-analysis-of-debates-around-mental-health-calls-in-the-prehospital-setting
#5
Polly Christine Ford-Jones, Claudia Chaufan
Paramedics, health care workers who assess and manage health concerns in the prehospital setting, are increasingly providing psychosocial care in response to a rise in mental health call volume. Observers have construed this fact as "misuse" of paramedic services, and proposed as solutions better triaging of patients, better mental health training of paramedics, and a greater number of community mental health services. In this commentary, we argue that despite the ostensibly well-intentioned nature of these solutions, they shift attention and accountability away from relevant public policies, as well as from broader economic, social, and political determinants of mental health, while placing responsibility on those requiring services or, at best, on the health care system...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28452251/mutual-distrust-perspectives-from-researchers-and-policy-makers-on-the-research-to-policy-gap-in-2013-and-recommendations-for-the-future
#6
Sarah E Gollust, Jane W Seymour, Maximilian J Pany, Adeline Goss, Zachary F Meisel, David Grande
The production of health policy-relevant research is necessary, but not sufficient, to promote its utilization in policy. Our objective was to understand the perspectives of United States' state-level policy makers and health researchers on the barriers and facilitators to the translation of health evidence into the policy process, with a particular focus on issues related to relationship building. We conducted interviews with 215 US health services and health policy researchers and 40 state-level staffers and legislators...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28351188/abortion-facility-closings-and-abortion-rates-in-texas
#7
Troy Quast, Fidel Gonzalez, Robert Ziemba
From 2004 to 2014, the overall abortion rate in Texas fell by almost a third from 10.7 to 7.2 abortions per 1000 women aged 10 to 49 years. During this same period, the number of abortion clinics operating at least 6 months in the year fell from 40 to 27. We examined the relationship between the abortion rate and the proximity of abortion facilities. We matched annual, county-level data on abortion rates in Texas from 2004 through 2014 with the distance from the county centroids to the nearest abortion facility in operation...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28301976/medicare-expenditures-associated-with-hospital-and-emergency-department-use-among-beneficiaries-with-dementia
#8
Laura Coots Daras, Zhanlian Feng, Joshua M Wiener, Yevgeniya Kaganova
Understanding expenditure patterns for hospital and emergency department (ED) use among individuals with dementia is crucial to controlling Medicare spending. We analyzed Health and Retirement Study data and Medicare claims, stratified by beneficiaries' residence and proximity to death, to estimate Medicare expenditures for all-cause and potentially avoidable hospitalizations and ED visits. Analysis was limited to the Medicare fee-for-service population age 65 and older. Compared with people without dementia, community residents with dementia had higher average expenditures for hospital and ED services; nursing home residents with dementia had lower average expenditures for all-cause hospitalizations...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28301971/medicaid-managed-care-and-the-health-care-utilization-of-foster-children
#9
Makayla Palmer, James Marton, Aaron Yelowitz, Jeffery Talbert
A recent trend in state Medicaid programs is the transition of vulnerable populations into Medicaid managed care (MMC) who were initially carved out of such coverage, such as foster children or those with disabilities. The purpose of this article is to evaluate the impact of the transition of foster children from fee-for-service Medicaid coverage to MMC coverage on outpatient health care utilization. There is very little empirical evidence on the impact of managed care on the health care utilization of foster children because of the recent timing of these transitions as well as challenges associated with finding data sets large enough to contain a sufficient number of foster children for such analysis...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28292193/raters-interpret-positively-and-negatively-worded-items-similarly-in-a-quality-of-life-instrument-for-children
#10
Chung-Ying Lin, Carol Strong, Meng-Che Tsai, Chih-Ting Lee
Measurement invariance is an important assumption to meaningfully compare children's quality of life (QoL) between different raters (eg, children and parents) and across genders. Moreover, QoL instruments may combine using negatively and positively worded items-a common method to reduce response bias. However, the wording effects may have different levels of impact on different raters and genders. Our aim was to investigate the measurement invariance of Kid-KINDL, a commonly used QoL instrument, across genders and raters and to consider the wording effects simultaneously...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28240040/primary-care-doctors-assessment-of-and-preferences-on-their-remuneration
#11
Stefanos Karakolias, Catherine Kastanioti, Mamas Theodorou, Nikolaos Polyzos
Despite numerous studies on primary care doctors' remuneration and their job satisfaction, few of them have quantified their views and preferences on certain types of remuneration. This study aimed at reporting these views and preferences on behalf of Greek doctors employed at public primary care. We applied a 13-item questionnaire to a random sample of 212 doctors at National Health Service health centers and their satellite clinics. The results showed that most doctors deem their salary lower than work produced and lower than that of private sector colleagues...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28220717/merger-acquisition-and-capital-expenditure-in-health-care
#12
Wenjing Ouyang, Peter E Hilsenrath
Investment, especially through merger and acquisition (M&A), is a leading topic of concern among health care managers. In addition, the implications of this activity for organization and market concentration are of great interest to policy makers. Using a sample of 2256 firm-year observations in the health care industry during the period from 1985 to 2011, this article provides novel evidence that managers learn from financial markets in making capital expenditure (CAPEX) and M&A investment decisions. Within the industry, managers in the Drugs subsector are most likely to do so, whereas managers in the Medical Equipment and Supplies are least likely to do so...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28147887/can-hospital-competition-really-affect-hospital-behavior-or-not-an-empirical-study-of-different-competition-measures-comparison-in-taiwan
#13
COMPARATIVE STUDY
Tsung-Hsien Yu, Yu-Chi Tung, Chung-Jen Wei
Different approaches to measure the hospital competition index might lead to inconsistent results of the effects of hospital competition on innovation adoption. The purpose of this study is to adopt a different approach to define market area and measure the level of competition to examine whether hospital competition has a positive effect on hospital behavior, taking quality indicator projects participation as an example. A total of 238 hospitals located in Taipei, Taichung, and Kaohsiung were recruited in this study...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28140760/validation-of-a-measure-of-chinese-outpatients-satisfaction-in-the-taiwan-setting
#14
James O Stanworth, Ryan Shuwei Hsu, Clyde A Warden
The medical services market is rapidly expanding around the world, following the experience of the industrialized Western economies. Cultural differences make existing assumptions about health care quality risky to export, leading to an increasing interest in understanding patient satisfaction with care within non-Western contexts. Within the Greater China region, both Western and traditional Chinese medicine coexist, yet there is a lack of research instruments that include distinct values of Chinese patients...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28140730/branding-palliative-care-units-by-avoiding-the-terms-palliative-and-hospice
#15
Ying-Xiu Dai, Tzeng-Ji Chen, Ming-Hwai Lin
The term "palliative care" has a negative connotation and may act as a barrier to early patient referrals. Rebranding has thus been proposed as a strategy to reduce the negative perceptions associated with palliative care. For example, using the term "supportive care" instead of "palliative care" in naming palliative care units has been proposed in several studies. In Taiwan, terms other than "palliative" and "hospice" are already widely used in the names of palliative care units. With this in mind, this study investigated the characteristics of palliative care unit names in order to better understand the role of naming in palliative care...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28133988/a-framework-for-determining-the-return-on-investment-of-simulation-based-training-in-health-care
#16
Hatim Bukhari, Pamela Andreatta, Brian Goldiez, Luis Rabelo
This article describes a framework that has been developed to monetize the real value of simulation-based training in health care. A significant consideration has been given to the incorporation of the intangible and qualitative benefits, not only the tangible and quantitative benefits of simulation-based training in health care. The framework builds from three works: the value measurement methodology (VMM) used by several departments of the US Government, a methodology documented in several books by Dr Jack Phillips to monetize various training approaches, and a traditional return on investment methodology put forth by Frost and Sullivan, and Immersion Medical...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28112020/establishing-a-cloud-computing-success-model-for-hospitals-in-taiwan
#17
Jiunn-Woei Lian
The purpose of this study is to understand the critical quality-related factors that affect cloud computing success of hospitals in Taiwan. In this study, private cloud computing is the major research target. The chief information officers participated in a questionnaire survey. The results indicate that the integration of trust into the information systems success model will have acceptable explanatory power to understand cloud computing success in the hospital. Moreover, information quality and system quality directly affect cloud computing satisfaction, whereas service quality indirectly affects the satisfaction through trust...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27932514/long-term-therapy-with-wu-ling-san-a-popular-antilithic-chinese-herbal-formula-did-not-prevent-subsequent-stone-surgery-a-nationwide-population-based-cohort-study
#18
San-Yuan Wu, Huey-Yi Chen, Kao-Sung Tsai, Jen-Huai Chiang, Chih-Hsin Muo, Fung-Chang Sung, Yung-Hsiang Chen, Wen-Chi Chen
Traditional Chinese herbal medicine (CHM), which is widely used to treat pain and urolithiasis, is a promising therapy for urinary stone prevention. This study investigated the clinical efficacy of a popular CHM, Wu-Ling-San (WLS), in Taiwan for the prophylaxis of recurrent nephrolithiasis as assessed by surgical stone treatment via a nationwide population-based cohort study. The National Health Insurance Research Database, 2000-2010, which included one million patient records. All patients diagnosed with stone disease at the beginning of the study...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27895218/a-new-approach-to-identify-high-burnout-medical-staffs-by-kernel-k-means-cluster-analysis-in-a-regional-teaching-hospital-in-taiwan
#19
Yii-Ching Lee, Shian-Chang Huang, Chih-Hsuan Huang, Hsin-Hung Wu
This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27856783/analysis-of-actual-versus-projected-medical-claims-under-the-first-year-of-aca-mandated-coverage
#20
Michael J McCue, Jennifer R Palazzolo
For the individual market, 2014 was the first year Affordable Care Act medical claims experience data were available to set 2016 rates. Accessing Centers for Medicare and Medicaid Services rate data for 175 state insurers, this study compares projected medical claims with actual medical claims of 2014, as well as the cost and utilization of benefit categories for inpatient, outpatient, professional, and prescription drug spending. Actual costs per member per month (pmpm) were greater than projected in 2014 for inpatient, outpatient, and prescription spending but not for professional care...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
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