Abstract:
OBJECTIVES:To assess the ability of an Adjusted Clinical Group (ACG)-based morbidity measure to assess the overall health service needs of populations. Data Sources/Study Setting. Three population-based secondary data sources: registration and health service utilization data from fiscal year 1995-1996; mortality data from vital statistics reports from 1996-1999; and Canadian census data. The study included all continuously enrolled residents in the universal health care plan in Manitoba. STUDY DESIGN:Using 60 small geographic areas as the units of analysis, we compared a population-based "ACG morbidity index," derived from individual ACG assignments in fiscal year 1995-1996, with the standardized mortality ratio (ages < 75 years) for 1996-1999. Key variables included a population-based socioeconomic status measure and age- and sex-standardized physician utilization ratios. DATA EXTRACTION METHODS:The ACGs were assigned based on the complement of diagnoses assigned to persons on physician claims and hospital separation abstracts. The ACG index was created by weighting the ACGs using average health care expenditures. PRINCIPAL FINDINGS:The ACG morbidity index had a strong positive linear relationship with the subsequent rate of premature death in the small areas of Manitoba. The ACG index was able to explain the majority of the relationships between mortality and both socioeconomic status and physician utilization. CONCLUSIONS:In Manitoba, ACGs are closely related to premature mortality, commonly accepted as the best single indicator for health service need in populations. Issues in applying ACGs in settings where needs adjustment is a primary objective are discussed.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Reid RJ,Roos NP,MacWilliam L,Frohlich N,Black Cdoi
10.1111/1475-6773.01029keywords:
subject
Has Abstractpub_date
2002-10-01 00:00:00pages
1345-64issue
5eissn
0017-9124issn
1475-6773journal_volume
37pub_type
杂志文章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'...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of health professionals' intervention on adherence to statins, the influence on total cholesterol levels, and lifestyle patterns in patients with hypercholesterolemia and analyze the differences according to the center of recruitment. STUDY SETTING:Forty-six community pharmacies and 50...
journal_title:Health services research
pub_type: 杂志文章,随机对照试验
doi:10.1111/1475-6773.13152
更新日期:2019-06-01 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: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 investigate whether the interaction between individual race/ethnicity and community racial/ethnic composition is associated with health-related home care use among elderly persons in the United States. DATA SOURCES:A nationally representative sample of community-dwelling elders aged 65+ from the 2000 to 2...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2010.01135.x
更新日期:2010-10-01 00:00:00
abstract:PURPOSE:We report the validation of an instrument to measure mistrust of health care organizations and examine the relationship between mistrust and health care service underutilization. METHODS:We conducted a telephone survey of a random sample of households in Baltimore City, MD. We surveyed 401 persons and followed...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.01017.x
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of a locally adapted evidence-based quality improvement (EBQI) approach to implementation of smoking cessation guidelines into routine practice. DATA SOURCES/STUDY SETTING:We used patient questionnaires, practice surveys, and administrative data in Veterans Health Administration (VA) p...
journal_title:Health services research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1475-6773.2008.00865.x
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To assess hospital and geographic variability in 30-day mortality after surgery for CRC and examine the extent to which sociodemographic, area-level, clinical, tumor, treatment, and hospital characteristics were associated with increased likelihood of 30-day mortality in a population-based sample of older CRC...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12171a
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:To explain the association of out-of-pocket (OOP) cost, community-level factors, and individual characteristics on statin therapy nonadherence. DATA SOURCES:BlueCross BlueShield of Texas claims data for the period of 2008-2011. STUDY DESIGN:A retrospective cohort of 49,176 insured patients, aged 18-64 years...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12547
更新日期:2017-08-01 00:00:00
abstract::In the recent past, a great deal of faith has been placed in the idea that the performance of the hospital industry could be improved significantly by relying more heavily on profit incentives. This article considers the effect of profit incentives on hospital behavior and finds that the existence of profit incentives...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1985-06-01 00:00:00
abstract::This article examines forces that influence physicians to change the percentage of their admissions to a hospital (loyalty) and to cease admitting patients to a hospital altogether (exit). Because physicians are both members of a hospital and consumers of its services, their admitting patterns can be described using m...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract:OBJECTIVE:To examine the impact of mandatory HMO enrollment for Medicaid-covered pregnant women on prenatal care use, smoking, Cesarean section (C-section) use, and birth weight. DATA SOURCES/STUDY SETTING:Linked birth certificate and Medicaid enrollment data from July 1993 to June 1998 in 10 Ohio counties, 6 that imp...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00260.x
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVES:To test whether state Certificate of Need (CON) regulations influence procedural mortality or the provision of coronary artery bypass graft surgery (CABG) and percutaneous coronary interventions (PCI). DATA SOURCES:Medicare inpatient claims obtained for 1989-2002 for patients age 65+ who received CABG or PC...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2008.00933.x
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:To investigate whether a performance-based contracting (PBC) system provides incentives for nonprofit providers of substance abuse treatment to select less severe clients into treatment. DATA SOURCES:The Maine Addiction Treatment System (MATS) standardized admission and discharge data provided by the Maine O...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00132
更新日期:2003-04-01 00:00:00
abstract::The cost of capital for hospitals is a topic of continuing interest as Medicare's new capital payment policy is implemented. This study examines the determinants of tax-exempt revenue bond yields, the primary source of long-term capital for hospitals. Two important methodological issues are addressed. A probit analysi...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVES:The primary aim of this article was to identify the latent failures that are perceived to underpin medication errors. STUDY SETTING:The study was conducted within three medical wards in a hospital in the United Kingdom. STUDY DESIGN:The study employed a cross-sectional qualitative design. DATA COLLECTION ...
journal_title:Health services research
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1475-6773.2012.01390.x
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:Independent freestanding emergency departments (IFEDs) have proliferated over the last decade, largely in Texas. We examined the IFED physician workforce composition and changes in emergency physician workforce supply across states and in rural Texas over the period of IFED proliferation following a 2009 legi...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13587
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To examine factors associated with guideline-concordant adjuvant therapy among breast cancer patients in a rural region of the United States and to present an advancement in quality-of-care assessment in the context of multiple treatments. DATA SOURCES:Chart abstraction on initial therapy received by 868 wom...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12269
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:To demonstrate the value of shrinkage estimators when calculating a composite quality measure as the weighted average of a set of individual quality indicators. DATA SOURCES:Rates of 28 quality indicators (QIs) calculated from the minimum dataset from residents of 112 Veterans Health Administration nursing h...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01437.x
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:This study examines whether parents' reports and ratings of pediatric health care vary by race/ethnicity and language in Medicaid managed care. DATA SOURCES:The data analyzed are from the National Consumer Assessment of Health Plans (CAHPS) Benchmarking Database 1.0 and consist of 9,540 children enrolled in ...
journal_title:Health services research
pub_type: 杂志文章,多中心研究
doi:
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:To quantify between-unit variability in mean length of stay (LoS) between intensive care units (ICUs) after adjusting for differences in case mix using a method that does not require arbitrary trimming of data. SETTING:An analysis of registry data from pediatric ICUs (PICUs) in Australia and New Zealand. ST...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01421.x
更新日期:2012-12-01 00:00:00
abstract::The National Long Term Care Demonstration (channeling) was designed to provide coordinated community-based long-term care services to those older persons at high risk of nursing home placement. A key component of the program was the process established to accomplish this targeting effort. In this article, the outreach...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract:OBJECTIVE:To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. DATA SOURCES:The primary data sources are the Medicare Cost Reports for 1998-2004 and hospital inpatient discharge data for three of the states where single sp...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2008.00881.x
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To assess the effects of an alternative method of paying home health agencies for services to Medicare beneficiaries, based on a demonstration program. DATA SOURCES/STUDY SETTING:Primary and secondary data collected on participating home health agencies in five states and their patients during the three-year...
journal_title:Health services research
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1997-10-01 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 review two indirect methods, geocoding and surname analysis, for estimating race/ethnicity as a means for health plans to assess disparities in care. STUDY DESIGN:Review of published articles and unpublished data on the use of geocoding and surname analyses. PRINCIPAL FINDINGS:Few published studies have ...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:10.1111/j.1475-6773.2006.00551.x
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:To examine the psychometric properties of a global physical functioning scale (GPFS) developed as a self-report measure and constructed to scale physical functioning from very poor (1) to excellent (100). DATA SOURCES:Data collection took place between January 1997 and September 1999. It consisted of self-ra...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:To examine the determinants of postsurgery length of stay (LOS) and inpatient mortality in the United States (California and Massachusetts) and Canada (Manitoba and Quebec). DATA SOURCES/STUDY SETTING:Patient discharge abstracts from the Agency for Health Care Policy and Research Nationwide Inpatient Sample ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract::Using a sample of 3,000 urban hospitals, this article examines the contributions of selected hospital characteristics to variations in hospital technical efficiencies, while it accounts for multiple products and inputs, and controls for local environmental variations. Four hospital characteristics are examined: hospit...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:To describe the insurance status of workers at small businesses, and to describe the status of uninsured persons by the employment characteristics (employment status, firm size, and whether the employer offers insurance) of the head of household. DATA SOURCES:Data from the March and February 2001 Current Pop...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00467.x
更新日期:2006-02-01 00:00:00