Abstract:
STUDY QUESTIONS:To determine factors that distinguish effective rural hospital consortia from ineffective ones in terms of their ability to improve members' financial performance. Two questions in particular were addressed: (1) Do large consortia have a greater collective impact on their members? (2) Does a consortium's economic environment determine the degree of collective impact on members? DATA SOURCES AND STUDY SETTING:Based on the hospital survey conducted during February 1992 by the Robert Wood Johnson Hospital-Based Rural Health Care project of rural hospital consortia. The survey data were augmented with data from Medicare Cost Reports (1985-1991), AHA Annual Surveys (1985-1991), and other secondary data. STUDY DESIGN:Dependent variables were total operating profit, cost per adjusted admission, and revenue per adjusted admission. Control variables included degree of group formalization, degree of inequality of resources among members (group asymmetry), affiliation with other consortium group(s), individual economic environment, common hospital characteristics (bed size, ownership type, system affiliation, case mix, etc.), year (1985-1991), and census region dummies. PRINCIPAL FINDINGS:All dependent variables have a curvilinear association with group size. The optimum group size is somewhere in the neighborhood of 45. This reveals the benefits of collective action (i.e., scale economies and/or synergy effects) and the issue of complexity as group size increases. Across analyses, no strong evidence exists of group economic environment impacts, and the environmental influences come mainly from the local economy rather than from the group economy. CONCLUSION:There may be some success stories of collaboration among hospitals in consortia, and consortium effects vary across different collaborations. RELEVANCE/IMPACT:When studying consortia, it makes sense to develop a typology of groups based on some performance indicators. The results of this study imply that government, rural communities, and consortium staff and steering committees should forge the consortium concept by expanding membership in order to gain greater financial benefits for individual hospitals.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Chan B,Feldman R,Manning WGkeywords:
subject
Has Abstractpub_date
1999-04-01 00:00:00pages
9-31issue
1 Pt 1eissn
0017-9124issn
1475-6773journal_volume
34pub_type
杂志文章abstract::A model is described that predicts hospital census and computes, for each day, the number of elective admissions that will maximize the census over the short run, subject to constraints on the probability of overflow. Where a computer is available the model provides detailed predictions of census in units as small as ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVES:To examine which components of medical homes affect time families spend arranging/coordinating health care for their children with special health care needs (CSHCNs) and providing health care at home. DATA SOURCES:2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN), a population-...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12215
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:To assess costs, effectiveness, and cost-effectiveness of inhaled corticosteroids (ICS) augmenting bronchodilator treatment for chronic obstructive pulmonary disease (COPD). DATA SOURCES:Claims between 1997 and 2005 from a large managed care database. STUDY DESIGN:Individual-level, fixed-effects regression ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2008.00879.x
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:To determine factors associated with ruptured appendicitis among children, using administrative databases. Insurance-related differences in the risk of ruptured appendix among adults in California have previously been described (Braveman, Schaaf, Egerter, et al. 1994). DATA SOURCES/STUDY SETTING:State of Mar...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVES:To compare the ability of two diagnosis-based risk adjustment systems and health self-report to predict short- and long-term mortality. DATA SOURCES/STUDY SETTING:Data were obtained from the Department of Veterans Affairs (VA) administrative databases. The study population was 78,164 VA beneficiaries at eig...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00622.x
更新日期:2007-04-01 00:00:00
abstract::This article describes a model development process that represents a useful step in classifying populations in terms of risk of institutionalization (Inst-Risk II). A four-category risk classification system--"High risk, Some risk, Low risk, and Very Low Risk"--was developed, based on combinations of measures of funct...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract::The strategic behaviors of small multihospital systems have received little attention in the literature despite the fact that small systems are the predominant scale among multihospital systems. This study examines one important aspect of small-system strategic behaviors: the birth-order or evolutionary patterns of ho...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1990-06-01 00:00:00
abstract::This article analyzes three methods used to forecast the transition of long-term care clients through a variety of possible home and facility placements and levels of care. The test population (N = 1,653) is derived from the larger population of clients admitted in 1978 to British Columbia's newly established Long-Ter...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract::Uniform hospital discharge abstract data from Maryland were used to examine the homogeneity of trauma-related DRGs with respect to a well-established measure of injury severity, the Injury Severity Score (ISS). Thirty DRGs were identified as including trauma cases with a wide range of severity; for each of these DRGs,...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1991-04-01 00:00:00
abstract:OBJECTIVE:To extend recent conceptual and methodological advances in disparities research to include the incorporation of genomic information in analyses of racial/ethnic disparities in health care and health outcomes. DATA SOURCES:Published literature on human genetic variation, the role of genetics in disease and re...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01413.x
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To efficiently estimate race/ethnicity using administrative records to facilitate health care organizations' efforts to address disparities when self-reported race/ethnicity data are unavailable. DATA SOURCE:Surname, geocoded residential address, and self-reported race/ethnicity from 1,973,362 enrollees of a...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2008.00854.x
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:Examination of the extent to which federal surveys provide the data needed to estimate the coverage/cost impacts of policy alternatives to address the problem of uninsurance. DATA SOURCES/STUDY SETTING:Assessment of the major federal household surveys that regularly provide information on health insurance an...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00544.x
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To determine whether Medicare enrollment at age 65 has an effect on the health trajectory of the near-elderly uninsured. DATA SOURCES:Eight biennial waves (1992-2006) of the Health and Retirement Study, a nationally representative panel survey of noninstitutionalized 51-61 year olds and their spouses. STUDY...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.00964.x
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:To test a conceptual model of relationships, reflection, sensemaking, and learning in primary care practices transitioning to patient-centered medical homes (PCMH). DATA SOURCES/STUDY SETTING:Primary data were collected as part of the American Academy of Family Physicians' National Demonstration Project of t...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12415
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To examine the impact of pay for performance in Medicaid on the quality and utilization of care. DATA SOURCES:Medicaid claims and encounter data in three intervention states (Pennsylvania, Minnesota, and Alabama) and three comparison states. STUDY DESIGN:Difference-in-difference analysis with propensity sco...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12426
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To understand public attitudes about and recommendations to address antibiotic overuse by employing public deliberation (a method for eliciting informed input on value-laden issues). DATA SOURCES/STUDY SETTING:Participants in 24 Community Deliberation groups (CD; n = 263), four Citizens' Panel groups (CP; n ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13175
更新日期:2019-12-01 00:00:00
abstract::In late 1982, as an alternative to Medicaid, Arizona implemented a prepaid, competitively bid medical care program--the Arizona Health Care Cost Containment System (AHCCCS). Before its introduction, the poor had been cared for primarily by a network of county-supported centers. Impact of the AHCCCS initiative was exam...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1985-08-01 00:00:00
abstract:OBJECTIVE:The rate of coronary artery bypass surgery (CABG) has been shown to vary greatly across geographic regions. This study examined whether these rates were associated with the rate of coronary artery angioplasty (PTCA) and with other community characteristics. DATA SOURCES/STUDY SETTING:The health care financin...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of the Nursing Home Value-Based Purchasing demonstration on quality of care and Medicare spending. DATA SOURCES/STUDY SETTING:Administrative and qualitative data from Arizona, New York, and Wisconsin nursing homes over the base-year (2008-2009) and 3-year (2009-2012) demonstration peri...
journal_title:Health services research
pub_type: 杂志文章,随机对照试验
doi:10.1111/1475-6773.12538
更新日期:2017-08-01 00:00:00
abstract::In this paper I propose a methodology for paying short-term general hospitals on the basis of prospective cost-based case-mix revenue budgets. A hospital's budget is divided into patient care--related components and other components. The patient care--related budget is based on the case mix of patients treated by the ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1980-07-01 00:00:00
abstract:OBJECTIVE:To examine the benefits of a high-performance work environment (HPWE) for employees, patients, and hospitals. STUDY SETTING:Forty-five adult, medical-surgical units in nine hospitals in upstate New York. STUDY DESIGN:Cross-sectional study. DATA COLLECTION:Surveys were collected from 1,527 unit-based hospit...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01438.x
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:To use statistical process control charts to monitor in-hospital outcomes at the hospital level for a wide range of procedures and diagnoses. DATA SOURCES:Routine English hospital admissions data. STUDY DESIGN:Retrospective analysis using risk-adjusted log-likelihood cumulative sum (CUSUM) charts, comparing...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00742.x
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:To describe the landscape of state antitrust activity and review related research and policy issues. In particular, to examine state laws that attempt to immunize mergers among healthcare providers from state and federal antitrust prosecution and consent decrees issued by state attorneys general permitting he...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:To determine whether (a) quality in schizophrenia care varies by race/ethnicity and over time and (b) these patterns differ across counties within states. DATA SOURCES:Medicaid claims data from California, Florida, New York, and North Carolina during 2002-2008. STUDY DESIGN:We studied black, Latino, and whi...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12296
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:The Standard Gamble (SG) technique is recommended for measurement of individuals' preferences under uncertainty and to express the outcome of different therapeutic choices in utility values to be used in clinical decision analysis and health program evaluation. The article alerts users of this technique to pr...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVE:To utilize functional status (FS) outcomes to benchmark outpatient therapy clinics. DATA SOURCES:Outpatient therapy data from clinics using Focus on Therapeutic Outcomes (FOTO) assessments. STUDY DESIGN:Retrospective analysis of 538 clinics, involving 2,040 therapists and 90,392 patients admitted July 2006-...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12344
更新日期:2016-04-01 00:00:00
abstract::This review summarizes the capabilities and contributions of quantitative sector models for understanding trends in hospital expenses and the effects thereon of various public policies. After some brief historical notes on the use of analogous models in other policy areas, the general classes of national, partial, and...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1985-02-01 00:00:00
abstract:OBJECTIVE:To determine the impact of rising health insurance premiums on coverage rates. DATA SOURCES & STUDY SETTING:Our analysis is based on two cohorts of nonelderly Americans residing in 64 large metropolitan statistical areas (MSAs) surveyed in the Current Population Survey in 1989-1991 and 1998-2000. Measures of...
journal_title:Health services research
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1475-6773.2005.00409.x
更新日期:2005-08-01 00:00:00
abstract::Can Medicare beneficiaries make rational and informed decisions about their coverage under the Medicare program? Recent policy developments in the Medicare program have been based on the theory of competition in medical care. One of the key assumptions of the competitive model is the free flow of adequate information,...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1988-12-01 00:00:00
abstract:OBJECTIVE:. To examine the effect of premiums and benefits on the health plan choices of older enrollees who choose Federal Employees Health Benefits Program (FEHBP) health plans as their primary payer. DATA SOURCES:Administrative enrollment data from the Office of Personnel Management (OPM) and plan premiums and bene...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00580.x
更新日期:2006-10-01 00:00:00