Abstract:
OBJECTIVE:This paper analyzes whether the rise in managed care during the 1990s caused the increase in hospital concentration. DATA SOURCES:We assemble data from the American Hospital Association, InterStudy and government censuses from 1990 to 2000. STUDY DESIGN:We employ linear regression analyses on long differenced data to estimate the impact of managed care penetration on hospital consolidation. Instrumental variable analogs of these regressions are also analyzed to control for potential endogeneity. DATA COLLECTION:All data are from secondary sources merged at the level of the Health Care Services Area. PRINCIPLE FINDINGS:In 1990, the mean population-weighted hospital Herfindahl-Hirschman index (HHI) in a Health Services Area was .19. By 2000, the HHI had risen to .26. Most of this increase in hospital concentration is due to hospital consolidation. Over the same time frame HMO penetration increased three fold. However, our regression analysis strongly implies that the rise of managed care did not cause the hospital consolidation wave. This finding is robust to a number of different specifications.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Town RJ,Wholey D,Feldman R,Burns LRdoi
10.1111/j.1475-6773.2006.00601.xsubject
Has Abstractpub_date
2007-02-01 00:00:00pages
219-38issue
1 Pt 1eissn
0017-9124issn
1475-6773pii
HESR601journal_volume
42pub_type
杂志文章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:OBJECTIVE:To examine whether physicians attend to gender prevalence data in diagnostic decision making for coronary heart disease (CHD) and to test the hypothesis that previously reported gender differences in CHD diagnostic certainty are due to discrimination arising from reliance on prevalence data ("statistical disc...
journal_title:Health services research
pub_type: 评论,杂志文章
doi:10.1111/j.1475-6773.2009.01022.x
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:To examine county-level geographic variation in treatment admissions among opioid treatment programs (OTPs) that accept Medicaid in the continental United States. DATA SOURCES/STUDY SETTING:Data come from the 2012 National Survey of Substance Abuse Treatment Services. STUDY DESIGN/DATA COLLECTION:We used lo...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12686
更新日期:2018-02-01 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 analyze differences in the determination of healthcare expenditures among racial/ethnic groups. DATA SOURCE:The 1987 National Medical Expenditure Survey, a nationally representative sample of the United States population. (Nomenclature reflects racial/ethnic categories as used in the Survey.) STUDY DESIG...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1998-10-01 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:OBJECTIVES:To examine variation in risk-adjusted reinsurance payments across Part D plans, analyze its implications for the program, and explore options to reduce reinsurance payments. DATA/STUDY DESIGN:2007-2015 Part D Plan Payment and Premium data; 2010-2013 Part D Prescription Drug Event data; and 2013 Part D Plan ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12866
更新日期:2018-12-01 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:This article compares judgments about the treatment of Dukes' B2 and C colon cancer made by general surgeons to those of internists and family practitioners. Physician and practice variables were specialty, affiliation with a Community Clinical Oncology Program (CCOP) hospital, time in practice, professional ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract:CONTEXT:A1c levels are widely used to assess quality of diabetes care provided by health care systems. Currently, cross-sectional measures are commonly used for such assessments. OBJECTIVE:To study within-patient longitudinal changes in A1c levels at Veterans Health Administration (VHA) facilities as an alternative to...
journal_title:Health services research
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1475-6773.2005.00439.x
更新日期:2005-12-01 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:OBJECTIVE:We estimate long-term health care costs of former smokers compared with continuing and never smokers using a retrospective cohort study of HMO enrollees. Previous research on health care costs associated with former smokers has suggested that quitters may incur greater health care costs than continuing smoker...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00142
更新日期:2003-04-01 00:00:00
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 t...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00509.x
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the role of health plan benefit design and price on consumers' decisions to purchase health insurance in the nongroup market and their choice of plan. DATA SOURCES AND STUDY SETTING:Administrative data from the three largest nongroup insurers in California and survey data about those insured in t...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00726.x
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:To examine trends in employer-sponsored health insurance coverage rates and its associated components between 2000 and 2008, to provide a baseline for later evaluations of the Affordable Care Act, and to provide information to policy makers as they design the implementation details of the law. DATA SOURCES:P...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01368.x
更新日期:2012-06-01 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: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: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:Examine the impact of the 2011 shortage of the drug cytarabine on patient receipt and timeliness of induction treatment for Acute Myeloid Leukemia (AML). STUDY DESIGN:A retrospective cohort was utilized to examine odds of receipt of inpatient induction chemotherapy and time to first dose across major (N = 10...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13028
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of depression treatment in primary care on patients' clinical status and employment, over six months. DATA SOURCES/STUDY SETTING:Data are from a randomized controlled trial of quality improvement for depression that included 938 adults with depressive disorder in 46 managed primary ca...
journal_title:Health services research
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1111/1475-6773.01086
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:To examine the implications of serious and chronic health problems on the willingness of enrollees to switch health plans if they are dissatisfied with their current arrangements. DATA SOURCE:A large (20,283 respondents) survey of employees of three national corporations committed to the model of managed com...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:To determine how the addition of generalist care managers and collaborative information technology to an ambulatory team affects the care of patients with diabetes. STUDY SETTING:Multiple ambulatory clinics within Intermountain Health Care (IHC), a large integrated delivery network. STUDY DESIGN:A retrospec...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00423.x
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:To determine whether Medicaid managed care is associated with lower hospitalization rates for ambulatory care sensitive conditions than Medicaid fee-for-service. We also explored whether there was a differential effect of Medicaid managed care by patient's race or ethnicity on the hospitalization rates for am...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00340.x
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:To assess optimal activity size/mix of Connecticut local public health jurisdictions, through estimating economies of scale/scope/specialization for environmental inspections/services. DATA SOURCES/STUDY SETTING:Connecticut's 74 local health jurisdictions (LHJs) must provide environmental health services, bu...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12740
更新日期:2017-12-01 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 examine the effect of rural hospital closures on the local economy. DATA SOURCES:U.S. Census Bureau, OSCAR, Medicare Cost Reports, and surveys of individuals knowledgeable about local hospital closures. STUDY DESIGN:Economic data at the county level for 1990-2000 were combined with information on hospita...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00497.x
更新日期:2006-04-01 00:00:00
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::We examined the expansion of Veterans Administration (now Department of Veterans Affairs--VA) inpatient psychiatric services from 1963 to 1984. Aggregate national trends in VA inpatient episodes between 1963 and 1984 document not only increased use of inpatient services but also "decentralization," or a shift to provi...
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 the extent to which the elimination of behavioral health benefits for selected beneficiaries of Oregon's Medicaid program affected general medical expenditures among enrollees using outpatient mental health and substance abuse treatment services. DATA SOURCE/STUDY SETTING:Twelve months of claims...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2008.00844.x
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:This study is designed to assess the cost of services provided to Medicare beneficiaries by nurse practitioners (NPs) billing under their own National Provider Identification number as compared to primary care physicians (PCMDs). DATA SOURCE:Medicare Part A (inpatient) and Part B (office visit) claims for 20...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12425
更新日期:2016-08-01 00:00:00