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

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https://www.readbyqxmd.com/read/28301976/medicare-expenditures-associated-with-hospital-and-emergency-department-use-among-beneficiaries-with-dementia
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27789732/new-medicaid-enrollees-see-health-and-social-benefits-in-pennsylvania-s-expansion
#14
Jeffrey K Hom, Charlene Wong, Christian Stillson, Jessica Zha, Carolyn C Cannuscio, Rachel Cahill, David Grande
Understanding how new Medicaid enrollees are approaching their own health and health care in the shifting health care landscape of the Affordable Care Act has implications for future outreach and enrollment efforts, as well as service planning for this population. The objective of this study was to explore the health care experiences and expectations of new Medicaid expansion beneficiaries in the immediate post-enrollment period. We conducted semistructured, qualitative interviews with a random sample of 40 adults in Philadelphia who had completed an application for Medicaid through a comprehensive benefits organization after January 1, 2015, when the Medicaid expansion in Pennsylvania took effect...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27683257/global-budget-payment-proposing-the-cap-framework
#15
Bradley Chen, Victoria Y Fan
To control ever-increasing costs, global budget payment has gained attention but has unclear impacts on health care systems. We propose the CAP framework that helps navigate 3 domains of difficult design choices in global budget payment: Constraints in resources (capitation vs facility-based budgeting; hard vs soft budget constraints), Agent-principal in resource allocation (individual vs group providers in resource allocation; single vs multiple pipes), and Price adjustment. We illustrate the framework with empirical examples and draw implications for policy makers...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27677519/microsimulation-modeling-of-coronary-heart-disease-maximizing-the-impact-of-nonprofit-hospital-based-interventions
#16
Peggy Vadillo Orenstein, Lu Shi
We use microsimulation to forecast changes in coronary heart disease (CHD) among adults 45 or above over a 20-year time horizon in Los Angeles County (N = 3.4 million), a county with 12‚ÄČ635 CHD deaths in 2010. We simulate individuals' life course and calibrate CHD trends to observed trends in the past. Using the Health Forecasting Community Health Simulation Model, we simulate CHD prevalence and CHD mortality in 2 CHD prevention scenarios: (1) "comprehensive hypertension intervention" and (2) "gradual reduction of the average adult body mass index back to the year 2000 level...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27637270/the-physical-and-psychological-health-of-migrants-in-guangzhou-china-how-does-neighborhood-matter
#17
Hongsheng Chen, Zhenjun Zhu, Dongqi Sun, Xingping Wang
This study analyzed the health of migrants in 4 types of neighborhood in the city of Guangzhou in China. The research shows that the health of internal migrants in urban villages and private housing neighborhoods is much better than those living in older inner city neighborhoods (which are known as jiefang shequ) and unit neighborhoods (which are known as danwei). The reasons behind this are the facts that the migrants in urban villages tend to be relatively young and there tend to be better social and economic conditions in the private housing neighborhood...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27637269/physicians-pharmaceutical-sales-representatives-interactions-and-conflict-of-interest-challenges-and-solutions
#18
Avinash R Patwardhan
Physician-industry relationships have come a long way since serious debates began after a 1990 Senate Committee on Labor and Human Resources report on the topic. On one side, the Sun Shine Act of 2007, now a part of the Patient Protection and Affordable Care Act that mandates disclosure of payments and gifts to the physicians, has injected more transparency into the relationships, and on the other side, numerous voluntary self-regulation guidelines have been instituted to protect patients. However, despite these commendable efforts, problem persists...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27637268/chest-pain-patients-at-veterans-hospitals-are-increasingly-more-likely-to-be-observed-than-admitted-for-short-stays
#19
Brad Wright, Amy M J O'Shea, Justin M Glasgow, Padmaja Ayyagari, Mary Vaughan Sarrazin
Observation stays are an outpatient service used to diagnose and treat patients for extended periods of time while a decision is made regarding inpatient admission or discharge. Although the use of observation stays is increasing, little is known about which patients are observed and which are admitted for similar periods of time as inpatients. The aim was to identify patient characteristics associated with being observed rather than admitted for a short stay (<48 hours) within the Veterans Health Administration (VHA)...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27530238/who-wants-long-term-care-insurance-a-stated-preference-survey-of-attitudes-beliefs-and-characteristics
#20
Benjamin T Allaire, Derek S Brown, Joshua M Wiener
Approximately half of people turning 65 years between 2015 and 2019 are projected to need long-term support and services. Yet the long-term care insurance (LTCI) market is depressed, with only 7.4 million people owning policies. The objective of this study was to provide an analysis of potential LTCI purchasers. We investigate (1) who wants to purchase LTCI, (2) what are the attitudes and beliefs among those who have a preference for LTCI, and (3) who would prefer a law mandating the purchase of LTCI and how that view relates to willingness to purchase LTC...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
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