Abstract:
OBJECTIVE:To determine whether difficulty walking and the strategies persons use to compensate for this deficit influenced downstream Medicare expenditures. DATA SOURCE:Secondary data analysis of Medicare claims data (1999-2000) for age-eligible Medicare beneficiaries (N=4,997) responding to the community portion of the 1999 National Long Term Care Survey (NLTCS). STUDY DESIGN:Longitudinal cohort study. Walking difficulty and compensatory strategy were measured at the 1999 NLTCS, and used to predict health care use as measured in Medicare claims data from the survey date through year-end 2000. DATA EXTRACTION:Respondents to the 1999 community NLTCS with complete information on key explanatory variables (walking difficulty and compensatory strategy) were linked with Medicare claims to define outcome variables (health care use and cost). PRINCIPAL FINDINGS:Persons who reported it was very difficult to walk had more downstream home health visits (1.1/month, p<.001), but fewer outpatient physician visits (-0.16/month, p<.001) after controlling for overall disease burden. Those using a compensatory strategy for walking also had increased home health visits/month (0.55 for equipment, 1.0 for personal assistance, p<.001 for both) but did not have significantly reduced outpatient visits. Persons reporting difficulty walking had increased downstream Medicare costs ranging from 163 US dollars to 222 US dollars/month (p<.001) depending upon how difficult walking was. Less than half of the persons who used equipment to adapt to walking difficulty had their difficulty fully compensated by the use of equipment. Persons using equipment that fully compensated their difficulty used around 300 US dollars/month less in Medicare-financed costs compared with those with residual difficulty. CONCLUSIONS:Difficulty walking and use of compensatory strategies are correlated with the use of Medicare-financed services. The potential impact on the Medicare program is large, given how common such limitations are among the elderly.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Taylor DH Jr,Hoenig Hdoi
10.1111/j.1475-6773.2006.00509.xsubject
Has Abstractpub_date
2006-06-01 00:00:00pages
743-58issue
3 Pt 1eissn
0017-9124issn
1475-6773pii
HESR509journal_volume
41pub_type
杂志文章abstract:OBJECTIVE:This article tests whether or not the factors that affect hospital choice differ for selected subgroups of the population. DATA SOURCES:1985 California Office of Statewide Health Planning and Development (OSHPD) discharge abstracts and hospital financial data were used. STUDY DESIGN:Models for hospital choi...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1993-06-01 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
abstract:OBJECTIVE:To examine the effect of post-hospital Medicare home health and informal care on the functional status of 755 Medicare beneficiaries six weeks after hospital discharge for treatment of stroke, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), hip procedures, and hip fractures. STU...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVE:We evaluate the impact of membership in a staff-model health maintenance organization (HMO) on hospital admission rates for patients presenting to an emergency department with acute chest pain. DATA SOURCES AND STUDY SETTING:Primary prospective data were gathered from all 3,006 patients presenting with a chi...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVE:This study examines the degree to which a married individual's health habits and use of preventive medical care are influenced by his or her spouse's behaviors. STUDY DESIGN:Using longitudinal data on individuals and their spouses, we examine changes over time in the health habits of each person as a functio...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00754.x
更新日期:2008-02-01 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:OBJECTIVES:To quantify racial and socioeconomic status (SES) disparities in oral health, as measured by tooth loss, and to determine the role of dental care use and other factors in explaining disparities. DATA SOURCES/STUDY SETTING:The Florida Dental Care Study, comprising African Americans (AAs) and non-Hispanic whi...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2003.00205.x
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:Patients discharged from a self-managed nursing unit are compared with patients from traditionally managed units on postdischarge outcomes. DATA SOURCES AND STUDY SETTING:Primary data were collected on patients discharged from eight nursing units in three clinical areas in one hospital from August through No...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract:RESEARCH OBJECTIVE:To investigate disenrollment from public insurance at the 6-year transitional birthday when eligibility for many children moves from Medicaid to State Children's Health Insurance Program (S-CHIP). DATA SOURCES:Data from Georgia's S-CHIP (PeachCare) and Medicaid programs from 2000 to 2002. STUDY DES...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00795.x
更新日期:2007-12-01 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:OBJECTIVE:To examine the association between bodyweight status and provision of population-based prevention services. DATA SOURCES:The National Association of City and County Health Officials 2005 Profile survey data, linked with two cross-sections of the Behavioral Risk Factor Surveillance System (BRFSS) survey in 20...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01447.x
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:During welfare reform, Congress passed legislation barring legal immigrants who entered the United States after August 1996 from Medicaid for five years after immigration. This legislation intended to bar only new immigrants (post-1996 immigrants) from Medicaid. However it may have also deterred the enrollme...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00301.x
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:To determine how the inclusion of post-acute evaluation and management (E&M) services as primary care affects assignment of Medicare beneficiaries to accountable care organizations (ACOs). DATA SOURCES:Medicare claims for a random 5 percent sample of 2009 Medicare beneficiaries linked to American Medical Ass...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12032
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To examine how case managers in a state-funded home care program allocate home care services in response to information about a client's Medicare home health care status, with particular attention to the influence of work environment. DATA SOURCES/STUDY SETTING:Primary data collected on 355 case managers and...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00176
更新日期:2003-10-01 00:00:00
abstract::This article examines the effect of owning long-term care insurance policies on the amount of out-of-pocket costs incurred by the elderly during their nursing home stays, and the importance of different policy features and restrictions. Data were drawn from the 1985 National Nursing Home Survey, and from copies of lon...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVE:To examine the effect of hospital volume on 30-day mortality for patients with congestive heart failure (CHF) using administrative and clinical data in conventional regression and instrumental variables (IV) estimation models. DATA SOURCES:The primary data consisted of longitudinal information on comorbid co...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00461.x
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To simplify the decision-making process, we propose and implement an approach to assess the stability of health plan performance over time when multiple indicators of performance exist. DATA SOURCE:National Committee for Quality Assurance Health Care Effectiveness Data and Information Set data for childhood ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2008.00890.x
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:To examine the effects of varying diagnostic and pharmaceutical criteria on the performance of claims-based algorithms for identifying beneficiaries with hypertension, heart failure, chronic lung disease, arthritis, glaucoma, and diabetes. STUDY SETTING:Secondary 1999-2000 data from two Medicare+Choice healt...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00321.x
更新日期:2004-12-01 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:Evidence supporting the use of public reporting of quality information to improve health care quality is mixed. While public reporting may improve reported quality, its effect on quality of care more broadly is uncertain. This study tests whether public reporting in the setting of nursing homes resulted in im...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.00967.x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:To develop and test a new outcome measure, Conditional Length of Stay (CLOS), to assess hospital performance when deaths are rare and complication data are not available. DATA SOURCES:The 1991 and 1992 MedisGroups National Comparative Data Base. STUDY DESIGN:We use engineering reliability theory traditional...
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 compare the performance of various risk adjustment models in behavioral health applications such as setting mental health and substance abuse (MH/SA) capitation payments or overall capitation payments for populations including MH/SA users. DATA SOURCES/STUDY DESIGN:The 1991-93 administrative data from the...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:To characterize the types of hospices with higher rates of patient disenrollment from the Medicare Hospice Benefit and the markets in which these hospices operate. DATA SOURCE:Secondary analyses of Surveillance, Epidemiology and End Results-Medicare data. Analyses included patients who died of cancer from 19...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.01002.x
更新日期:2009-12-01 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:OBJECTIVE:To assess the impact of hospital affiliation, centralization, and managed care plan ownership on inpatient cost and quality. DATA SOURCES:Inpatient discharges from 3,957 community hospitals in 44 states and American Hospital Association Annual Survey data from 2010 to 2012. STUDY DESIGN:We conducted a retro...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12631
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To investigate how changes in insurer participation and composition as well as state policies affect health plan affordability for individual market enrollees. DATA SOURCES:2014-2019 Qualified Health Plan Landscape Files augmented with supplementary insurer-level information. STUDY DESIGN:We measured plan a...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13190
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVES:To explore effects of disease prevalence adjustment on ambulatory care-sensitive hospitalization (ACSH) rates used for quality comparisons. DATA SOURCES/STUDY SETTING:County-level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12680
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To estimate the impact of implementing prescription drug monitoring program (PDMP) best practices on prescription opioid use. DATA SOURCES:2007-2012 Medicare claims for noncancer pain patients, and PDMP attributes from the Prescription Drug Abuse Policy System. STUDY DESIGN:We derived PDMP composite scores ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13197
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:This study describes the derivation and validation of the Patient Management Category (PMC) Severity Scale, which provides a method of assessing the overall severity of a hospitalized patient's illnesses, based on the patient's unique clinical conditions, their interaction, and the resultant, combined risk of...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1994-08-01 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