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

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https://www.readbyqxmd.com/read/28741398/effects-of-role-playing-scenarios-on-the-self-efficacy-of-students-in-resisting-against-substance-addiction-a-pilot-study
#1
Gülnaz Karatay, Nazan Gürarslan Baş
During the first phases of adolescent development, young people have little self-efficacy and resistance against substance use. The aim of this study was to demonstrate the effectiveness of role-playing scenarios on the self-efficacy of students in resisting substance use. A pre test and post test study design was used with a single group. The study was carried out with 245 secondary school students. The scenario-based training, developed by the researchers, was presented by the school counselors once a week for 4 weeks...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28660771/service-quality-assessment-of-hospitals-in-asian-context-an-empirical-evidence-from-pakistan
#2
Muhammad Shafiq, Muhammad Azhar Naeem, Zartasha Munawar, Iram Fatima
Hospitals vary from one another in terms of their specialty, services offered, and resource availability. Their services are widely measured with scales that gauge patients' perspective. Therefore, there is a need for research to develop a scale that measures hospital service quality in Asian hospitals, regardless of their nature or ownership. To address this research need, this study adapted the SERVQUAL instrument to develop a service quality measurement scale. Data were collected from inpatients and outpatients at 9 different hospitals, and the scale was developed using structural equation modeling...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28617202/hospital-capital-investment-during-the-great-recession
#3
Sung Choi
Hospital capital investment is important for acquiring and maintaining technology and equipment needed to provide health care. Reduction in capital investment by a hospital has negative implications for patient outcomes. Most hospitals rely on debt and internal cash flow to fund capital investment. The great recession may have made it difficult for hospitals to borrow, thus reducing their capital investment. I investigated the impact of the great recession on capital investment made by California hospitals...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28617196/factors-associated-with-having-a-physician-nurse-practitioner-or-physician-assistant-as-primary-care-provider-for-veterans-with-diabetes-mellitus
#4
Perri Morgan, Christine M Everett, Valerie A Smith, Sandra Woolson, David Edelman, Cristina C Hendrix, Theodore S Z Berkowitz, Brandolyn White, George L Jackson
Expanded use of nurse practitioners (NPs) and physician assistants (PAs) is a potential solution to workforce issues, but little is known about how NPs and PAs can best be used. Our study examines whether medical and social complexity of patients is associated with whether their primary care provider (PCP) type is a physician, NP, or PA. In this national retrospective cohort study, we use 2012-2013 national Veterans Administration (VA) electronic health record data from 374 223 veterans to examine whether PCP type is associated with patient, clinic, and state-level factors representing medical and social complexity, adjusting for all variables simultaneously using a generalized logit model...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28617065/unmet-needs-for-family-caregivers-of-elderly-people-with-dementia-living-in-italy-what-do-we-know-so-far-and-what-should-we-do-next
#5
Maria C De Cola, Viviana Lo Buono, Agata Mento, Mariella Foti, Silvia Marino, Placido Bramanti, Alfredo Manuli, Rocco S Calabrò
Care of the elderly with dementia represents one of the major challenges for the modern society worldwide. The burden of dementia care often falls on the family members, entailing heavy psychosocial and economic consequences. The aim of this study was to evaluate the caregiver's perspective concerning the support for disease management on behalf of the physicians and the local Sicilian administrations (Italy), and the burden of care and effects on their lifestyle, to propose new prevention strategies and service for managing dementia and caregiver's burden...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28604260/developing-high-functioning-teams-factors-associated-with-operating-as-a-real-team-and-implications-for-patient-centered-medical-home-development
#6
Somava Stout, Leah Zallman, Lisa Arsenault, Assaad Sayah, Karen Hacker
Team-based care is a foundation of health care redesign models like the patient-centered medical home (PCMH). Yet few practices rigorously examine how the implementation of PCMH relates to teamwork. We identified factors associated with the perception of a practice operating as a real team. An online workforce survey was conducted with all staff of 12 primary care sites of Cambridge Health Alliance at different stages of PCMH transformation. Bivariate and multivariate analyses of factors associated with teamwork perceptions were conducted...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28597725/physicians-voices-what-skills-and-supports-are-needed-for-effective-practice-in-an-integrated-delivery-system-a-case-study-of-kaiser-permanente
#7
Benjamin Chesluk, Laura Tollen, Joy Lewis, Samantha DuPont, Marc H Klau
Payers are demanding that US health care become more accountable and integrated, posing new demands for physicians and the organizations that partner with them. We conducted focus groups with 30 physicians in a large integrated delivery system who had previous experience practicing in less integrated settings and asked about skills they need to succeed in this environment. Physicians identified 3 primary skills: orienting to teams and systems, engaging patients as individuals and as a panel, and integrating cost awareness into practice...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28578608/do-gender-predominant-primary-health-care-organizations-have-an-impact-on-patient-experience-of-care-use-of-services-and-unmet-needs
#8
Raynald Pineault, Roxane Borgès Da Silva, Sylvie Provost, Michel Fournier, Alexandre Prud'homme, Jean-Frédéric Levesque
Physicians' gender can have an impact on many aspects of patient experience of care. Organization processes through which the influence of gender is exerted have not been fully explored. The aim of this article is to compare primary health care (PHC) organizations in which female or male doctors are predominant regarding organization and patient characteristics, and to assess their influence on experience of care, preventive care delivery, use of services, and unmet needs. In 2010, we conducted surveys of a population stratified sample (N = 9180) and of all PHC organizations (N = 606) in 2 regions of the province of Québec, Canada...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28578605/mortality-differences-between-traditional-medicare-and-medicare-advantage-a-risk-adjusted-assessment-using-claims-data
#9
Roy A Beveridge, Sean M Mendes, Arial Caplan, Teresa L Rogstad, Vanessa Olson, Meredith C Williams, Jacquelyn M McRae, Stefan Vargas
Medicare Advantage (MA) has grown rapidly since the Affordable Care Act; nearly one-third of Medicare beneficiaries now choose MA. An assessment of the comparative value of the 2 options is confounded by an apparent selection bias favoring MA, as reflected in mortality differences. Previous assessments have been hampered by lack of access to claims diagnosis data for the MA population. An indirect comparison of mortality as an outcome variable was conducted by modeling mortality on a traditional fee-for-service (FFS) Medicare data set, applying the model to an MA data set, and then evaluating the ratio of actual-to-predicted mortality in the MA data set...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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