Abstract:
:De-hospitalization of cancer treatment, particularly for those with advanced disease, can complicate adjustment and strain the capacity of caregiver networks to meet patients' daily needs. Outpatient staff should be able to recognize patients who need help to meet their daily needs as well as those who are not getting enough help. This study describes the physiological and social determinants of need and unmet need for assistance among 629 cancer patients with advanced disease initiating a course of outpatient chemotherapy and/or radiation therapy. Areas of needs examined through telephone interviews with participating patients were: personal care, instrumental tasks (housework, shopping, and cooking), and transportation. Physiological factors (metastases, disease stage, and functional status) were associated with need for assistance in all three areas. Also, older age (over 65) and low income predicted need for help with personal care, and women were more likely than men to report illness-related need for assistance with instrumental tasks and transportation. Unmet need was primarily associated with patients' social support system (e.g., children living nearby and perceived resiliency of network helpers). These findings highlight the need for outpatient staff to evaluate patients' informal care resources as well as patients' symptoms and impairments in deciding who should be referred for home care services.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Mor V,Allen SM,Siegel K,Houts Pkeywords:
subject
Has Abstractpub_date
1992-08-01 00:00:00pages
337-60issue
3eissn
0017-9124issn
1475-6773journal_volume
27pub_type
杂志文章abstract:OBJECTIVE:To develop and validate a disease-specific automated inpatient mortality risk adjustment system primarily using computerized numerical laboratory data and supplementing them with administrative data. To assess the values of additional manually abstracted data. METHODS:Using 1,271,663 discharges in 2000-2001,...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2010.01126.x
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:To translate a set of evidence-based clinical standards designed to allow paramedics to forego unnecessary and potentially harmful resuscitation attempts into a feasible new policy. DATA SOURCES/SETTING:Policy documents, meeting minutes, and personal communications between a large urban Emergency Medical Ser...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01341.x
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To examine whether disparities in health care experiences of Medicare beneficiaries differ between managed care (Medicare Advantage [MA]) and traditional fee-for-service (FFS) Medicare. DATA SOURCES:132,937 MA and 201,444 FFS respondents to the 2007 Medicare Consumer Assessment of Health Care Providers and S...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01245.x
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:To test whether concordance or discordance of patient participation between patients and physicians is associated with higher satisfaction, and to examine the effects of patients' and physicians' participatory styles on patients' satisfaction with their physicians. DATA:Data collected in the Texas Tech 5000...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00233.x
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:The design of health insurance, and the role out-of-pocket (OOP) payments play in it, is a key policy issue as rising health costs have encouraged greater cost-sharing measures. This paper compares the percentage of Americans spending large amounts OOP to meet their health needs with percentages in eight othe...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12444
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To understand reasons why California has lower Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores than the rest of the country, including differing patterns of CAHPS scores between Medicare Advantage (MA) and fee-for-service, effects of additional demographic characteristics of beneficiari...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01279.x
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To quantify the impact of multiyear utilization of preventive dental services on downstream dental care utilization and expenditures for children. DATA SOURCES/STUDY SETTING:We followed 0.93 million Medicaid-enrolled children who were 3-6 years old in 2005 from 2005 to 2011. We used Medicaid claims data of A...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12811
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To compare process of care and outcome after acute myocardial infarction, for patients with and without mental illness, cared for in the Veterans Health Administration (VA) health care system. DATA SOURCES/SETTING:Primary clinical data from 81 VA hospitals. STUDY DESIGN:This was a retrospective cohort study...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00104
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:Substantial investment in electronic health records (EHRs) has provided an unprecedented opportunity to use clinical decision support (CDS) to increase guideline adherence. To inform efforts to maximize adoption, we characterized the adoption of an otitis media (OM) CDS system, the impact of performance feedb...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12240
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:To explore why and how health systems are engaging in care delivery redesign (CDR)-defined as the variety of tools and organizational change processes health systems use to pursue the Triple Aim. STUDY SETTING:A purposive sample of 24 health systems across 4 states as part of the Agency for Healthcare Resear...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13585
更新日期:2020-12-01 00:00:00
abstract::A location model is used to determine the most efficient (i.e., least-cost) number and location of ambulance facilities in a rural area. The model incorporates response time and service time standards into the analysis and indicates the trade-off between costs and various time standards. The financial feasibility of i...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1977-10-01 00:00:00
abstract:OBJECTIVE:To compare utilization and preventive care receipt among patients of federal Section 330 health centers (HCs) versus patients of other settings. DATA SOURCES:A nationally representative sample of adults from the Medical Expenditure Panel Survey (2004-2008). STUDY DESIGN:HC patients were defined as those wit...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12178
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:Microsimulation was used to assess the financial impact on hospitals of a surge in influenza admissions in advance of the H1N1 pandemic in the fall of 2009. The goal was to estimate net income and losses (nationally, and by hospital type) of a response of filling unused hospital bed capacity proportionately a...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12041
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To estimate county-level associations between in utero exposure to threatened evictions and preterm birth in the United States. DATA SOURCES:Complete birth records were obtained from the National Center for Health Statistics (2009-2016). Threatened evictions were measured at the county level using eviction c...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13551
更新日期:2020-10-01 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:INTRODUCTION:America's community health centers (HCs) are uniquely poised to implement the patient-centered medical home (PCMH) model, as they are effective in providing comprehensive, accessible, and continuous primary care. This study aims to evaluate the relationship between PCMH recognition in HCs and clinical perf...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12523
更新日期:2017-06-01 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::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 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::Mr. Zamberlan is one of seven major executives in the Department of Veterans Affairs (VA) Veterans Health Services and Research Administration (VHS&RA), directing health care in a five-state region that includes 21 medical centers, 7 outpatient clinics, and 19 veterans outreach centers. As a medical center director in...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVE:To determine if sufficient nurse staffing reduced in-hospital fractures in acute care hospitals. DATA SOURCES/STUDY SETTING:The Japanese Diagnosis Procedure Combination inpatient (DPC) database from July 2010 to March 2014 linked with the Surveys for Medical Institutions. STUDY DESIGN:We conducted a retrosp...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12529
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:To compare medical care costs and utilization in a consumer-driven health plan (CDHP) to other health insurance plans. STUDY DESIGN:We examine claims and employee demographic data from one large employer that adopted a CDHP in 2001. A quasi-experimental pre-post design is used to assign employees to three co...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00282.x
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVE:To compare estimates of health coverage from the pre- and post- redesign of the Current Population Survey (CPS) Annual Social and Economic Supplement. DATA SOURCES/STUDY SETTING:The CPS 2013 Content Test. STUDY DESIGN:A test of the old and new CPS in which the control panel was a subset of the CPS productio...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12312
更新日期:2016-02-01 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::Two indexes are described, based on measures of administrative effectiveness and patient care effectiveness. The measures used were selected and ranked by a Delphi panel from a list of 30 measures drawn from the literature. Weights were assigned by the panel to 19 selected measures. The resulting indexes did well in a...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1976-10-01 00:00:00
abstract:OBJECTIVE:We study the association between the timing of the Great Recession (GR) and health spending among uninsured adults distinguishing by citizenship/nativity status and time of U.S. residence. DATA SOURCE:Uninsured U.S. citizens and noncitizens from the 2005-2006 and 2008-2009 Medical Expenditure Panel Survey. ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12193
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:To assess the impact of Enroll America's field outreach activities on the number of individuals enrolled in Marketplace coverage during the first open enrollment period. DATA SOURCES/STUDY SETTING:Marketplace enrollment for the initial open enrollment period linked with data on Enroll America's field activit...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12630
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To develop and test a caregiver-reported experience measure for pediatric hospital-to-home transitions. DATA SOURCES/STUDY SETTING:Primary data were collected between 07/2014 and 05/2015 from caregivers within 2-8 weeks of their child's discharge from a tertiary care children's hospital. STUDY DESIGN/DATA C...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12864
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To test whether nonprofit, for-profit, or government hospital ownership affects medical service provision in rural hospital markets, either directly or through the spillover effects of ownership mix. DATA SOURCES/STUDY SETTING:Data are from the American Hospital Association, U.S. Census, CMS Healthcare Cost ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01280.x
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To determine whether Medicaid home care spending reduces the proportion of the disabled elderly population who do not get help with personal care. DATA SOURCES:Data on Medicaid home care spending per poor elderly person in each state is merged with data from the Medicare Current Beneficiary Survey for 1992, ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00762.x
更新日期:2008-02-01 00:00:00