Abstract：
:All admissions to a 1,100-bed Department of Veterans Affairs (VA) hospital were screened to identify 171 terminally ill patients with informal caregivers who were then randomly assigned to VA hospital-based team home care (HBHC, N = 85) or customary care (N = 86). Patient functioning, and patient and caregiver morale and satisfaction with care were measured at baseline, one month, and six months. Health services utilization was monitored over the six-month study period and converted to cost. Findings included no differences in patient survival, activities of daily living (ADL), cognitive functioning, or morale, but a significant increase in patient (p = .02) and caregiver (p = .005) satisfaction with care at one month. A substitution effect of HBHC was seen. Those in the experimental group used 5.9 fewer VA hospital days (p = .03), resulting in a $1,639 or 47 percent per capita saving in VA hospital costs (p = .02). As a result, total per capita health care costs, including HBHC, were $769 or 18 percent (n.s.) lower in the HBHC sample, indicating that expansion of VA HBHC to serve terminally ill veterans would increase satisfaction with care at no additional cost.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Hughes SL,Cummings J,Weaver F,Manheim L,Braun B,Conrad Ksubject
Has Abstractpub_date
1992-02-01 00:00:00pages
801-17issue
6eissn
0017-9124issn
1475-6773journal_volume
26pub_type
临床试验,杂志文章,随机对照试验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: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：: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:To assess the association between aggregate unemployment and hospital discharges for acute myocardial infarction (AMI) among adults and seniors, 1995-2011. DATA SOURCES/STUDY SETTING:Community hospital discharge data from states collected for the Healthcare Cost and Utilization Project (HCUP) State Inpatient...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12298
更新日期：2015-10-01 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：:Alternative delivery systems, such as HMOs, PPOs, and primary care case-management programs, have a long history in rural America despite significant impediments to their development. However, little is known about the effect of these systems on rural communities and their medical care delivery systems. Existing studi...
journal_title：Health services research
pub_type： 历史文章,杂志文章,评审
doi：
更新日期：1989-02-01 00:00:00
abstract：OBJECTIVE:To assess the value of a novel composite measure for identifying the best hospitals for major procedures. DATA SOURCE:We used national Medicare data for patients undergoing five high-risk surgical procedures between 2005 and 2008. STUDY DESIGN:For each procedure, we used empirical Bayes techniques to create...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2012.01407.x
更新日期：2012-10-01 00:00:00
abstract：OBJECTIVE:To assess relationships between changes in Medicare Advantage (MA) payment rates and Medicare beneficiary hospitalizations and to simulate the effects of scheduled payment cuts on ambulatory care sensitive (ACS) and elective hospitalization rates. DATA:State Inpatient Database discharge abstracts from Arizon...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01275.x
更新日期：2011-10-01 00:00:00
abstract：OBJECTIVE:To examine factors associated with Medicaid acceptance for substance abuse (SA) services by outpatient SA treatment programs. DATA SOURCES:Secondary analysis of 2003-2006 National Survey of Substance Abuse Treatment Services data combined with state Medicaid policy and usage measures and other publicly avail...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01206.x
更新日期：2011-04-01 00:00:00
abstract：OBJECTIVES:To assess the use and timing of scheduled cesareans and other categories of cesarean delivery and the prevalence of neonatal morbidity among cesareans in Oregon before and after the implementation of Oregon's statewide policy limiting elective early deliveries. DATA SOURCES:Oregon vital statistics records, ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12797
更新日期：2018-08-01 00:00:00
abstract：:This paper addresses two questions: (1) Does adjusting for case mix have any effect on prospective admission-based reimbursement? and (2) How does the way in which case type is defined (DRG, ICD9CM, Age, etc) affect reimbursement systems? Data from 20 Maryland hospitals provided the basis for analysis, and the results...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1983-07-01 00:00:00
abstract：OBJECTIVE:To evaluate whether community-based health insurance (CBHI) protects household assets in rural Burkina Faso, Africa. DATA SOURCES:Data were used from a household panel survey that collected primary data from randomly selected households, covering 41 villages and one town, during 2004-2007(n = 890). STUDY DE...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01321.x
更新日期：2012-04-01 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 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：: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 test the hypothesis that health systems provide better care to patients with high needs by comparing differences in quality between system-affiliated and nonaffiliated physician organizations (POs) and to examine variability in quality across health systems. DATA SOURCES:2015 Medicare Data on Provider Pra...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13570
更新日期：2020-12-01 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：: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：OBJECTIVES:To study the impact of eliminating cost sharing for screening mammography on mammography rates in a large Medicare Advantage (MA) health plan which in 2010 eliminated cost sharing in anticipation of the Affordable Care Act mandate. STUDY SETTING:Large MA health maintenance organization offering individual-s...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12486
更新日期：2017-02-01 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：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：:Previous research has confirmed that desirable hospital attributes as well as increased distance, or travel time, have an impact on hospital choice. These studies have become increasingly sophisticated in modeling choice. This study adds to the existing literature by estimating the effect of both hospital and individu...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1991-12-01 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：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：BACKGROUND:The extent to which patient experiences with hospital care are related to other measures of hospital quality and safety is unknown. METHODS; We examined the relationship between Hospital Consumer Assessment of Healthcare Providers and Systems scores and technical measures of quality and safety using service-...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01122.x
更新日期：2010-08-01 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：:In a randomized trial of the effects of medical insurance on spending and the health status of the nonaged, we previously reported that patients with limited cost sharing had approximately one-third less use of medical services, similar general self-assessed health, and worse blood pressure, functional far vision, and...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1987-08-01 00:00:00
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...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1992-08-01 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 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
