Abstract：
OBJECTIVE:To use statistical process control charts to monitor in-hospital outcomes at the hospital level for a wide range of procedures and diagnoses. DATA SOURCES:Routine English hospital admissions data. STUDY DESIGN:Retrospective analysis using risk-adjusted log-likelihood cumulative sum (CUSUM) charts, comparing each hospital with the national average and its peers for in-hospital mortality, length of stay, and emergency readmission within 28 days. DATA COLLECTION:Data were derived from the Department of Health administrative hospital admissions database, with monthly uploads from the clearing service. PRINCIPAL FINDINGS:The tool is currently being used by nearly 100 hospitals and also a number of primary care trusts responsible for purchasing hospital care. It monitors around 80 percent of admissions and in-hospital deaths. Case-mix adjustment gives values for the area under the receiver operating characteristic curve between 0.60 and 0.86 for mortality, but the values were poorer for readmission. CONCLUSIONS:CUSUMs are a promising management tool for managers and clinicians for driving improvement in hospital performance for a range of outcomes, and interactive presentation via a web-based front end has been well received by users. Our methods act as a focus for intelligently directed clinical audit with the real potential to improve outcomes, but wider availability and prospective monitoring are required to fully assess the method's utility.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Bottle A,Aylin Pdoi
10.1111/j.1475-6773.2007.00742.xsubject
Has Abstractpub_date
2008-02-01 00:00:00pages
10-31issue
1 Pt 1eissn
0017-9124issn
1475-6773journal_volume
43pub_type
杂志文章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：STUDY QUESTION:Continuous quality improvement (CQI) has been implemented at least to some degree in many health care settings, yet randomized controlled trials (RCTs) of CQI are rare. We ask whether, when, and how RCTs of CQI might be designed. STUDY DESIGN:We consider two applications of CQI: as a general philosophy ...
journal_title：Health services research
pub_type： 评论,杂志文章
doi：
更新日期：2000-08-01 00:00:00
abstract：OBJECTIVE:To examine the relationship of services for post-acute care (PAC) to stroke patient outcomes. DATA SOURCES/STUDY SETTING:Veterans Health Administration (VHA) hospitals from two facility-level surveys and extant data files. STUDY DESIGN:Cross-sectional study of veterans hospitalized with acute stroke during ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2001-02-01 00:00:00
abstract：OBJECTIVE:To assess the effectiveness and cost-effectiveness of four treatment modalities for substance abuse. DATA SOURCES:The study used data from the Services Research Outcomes Study (SROS), a survey of 3,047 clients in a random sample of 99 drug treatment facilities across the United States. Detailed sociodemograp...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.00114
更新日期：2003-02-01 00:00:00
abstract：OBJECTIVE:To examine the factors associated with delivery of preterm infants at neonatal intensive care unit (NICU) hospitals in Arkansas during the period 2001-2006, with a focus on the impact of a Medicaid supported intervention, Antenatal and Neonatal Guidelines, Education, and Learning System (ANGELS), that expande...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01249.x
更新日期：2011-08-01 00:00:00
abstract：OBJECTIVES:(1) To present the Behavioral Model for Vulnerable Populations, a major revision of a leading model of access to care that is particularly applicable to vulnerable populations; and (2) to test the model in a prospective study designed to define and determine predictors of the course of health services utiliz...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2000-02-01 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 investigate the role of smoking cessation in body weight. DATA SOURCES:2004-2005 and 2009-2010 Behavioral Risk Factor Surveillance Surveys (BRFSS) (N = 349,000), Centers for Disease Control and Prevention; Tax Burden on Tobacco (Orzechowski and Walker 2010). STUDY DESIGN:The Gaussian treatment effect mod...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2012.01380.x
更新日期：2012-08-01 00:00:00
abstract：OBJECTIVE:To examine the influence of place of graduate medical education (GME), state licensure requirements, presence of established international medical graduates (IMGs), and ethnic communities on the initial practice location choices of new IMGs. DATA SOURCES:The annual Graduate Medical Education (GME) Survey of ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1034/j.1600-0560.2002.58.x
更新日期：2002-08-01 00:00:00
abstract：:Limited information exists concerning lifetime use of nursing home services by the aged. This article examines the longitudinal experience, over four years, of elderly individuals at high risk of institutionalization, and develops a simple model of nursing home use based on these observations. This model allows us to ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1986-06-01 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：OBJECTIVE:To produce cost estimates of proposed health insurance benefit mandates for the California legislature. DATA SOURCES:The 2001 California Health Interview Survey, 2002 Kaiser Family Foundation/Health Research and Education Trust California Employer Health Benefits Survey, Milliman Health Cost Guidelines, and ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00518.x
更新日期：2006-06-01 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：: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 examine whether parental beliefs about routine checkups are associated with children's receipt of timely preventive care. DATA SOURCES:The 2001 United Way Outcomes and Community Impact Program telephone survey of San Diego County, including 918 households with children between 3 and 19 years of age, where...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00759.x
更新日期：2008-02-01 00:00:00
abstract：OBJECTIVE:To determine the impact of rising health insurance premiums on coverage rates. DATA SOURCES & STUDY SETTING:Our analysis is based on two cohorts of nonelderly Americans residing in 64 large metropolitan statistical areas (MSAs) surveyed in the Current Population Survey in 1989-1991 and 1998-2000. Measures of...
journal_title：Health services research
pub_type： 杂志文章,多中心研究
doi：10.1111/j.1475-6773.2005.00409.x
更新日期：2005-08-01 00:00:00
abstract：OBJECTIVES:To synthesize lessons learned from the experiences of Agency for Healthcare Research and Quality-funded patient safety projects in implementing safe practices. DATA SOURCES:Self-reported data from individual and group interviews with Original, Challenge, and Partnerships in Implementing Patient Safety (PIPS...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2008.00929.x
更新日期：2009-04-01 00:00:00
abstract：OBJECTIVE:To assess the effect of dissemination and implementation of an intervention consisting of practice facilitation and a risk-stratified, population management dashboard on cardiovascular risk reduction for patients at high risk in small, primary care practices. STUDY SETTING:A total of 219 small primary care p...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13571
更新日期：2020-12-01 00:00:00
abstract：OBJECTIVE:The volume and cost of services consumed by persons with AIDS (PWAs) during their last months of life are examined in this study. DATA SOURCES:This study utilizes data from the AIDS Costs and Service Utilization Survey (ACSUS). The ACSUS is the most comprehensive survey of medical services that are consumed ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1994-12-01 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 examine whether nurse practitioner (NP)-assigned patients exhibited differences in utilization, costs, and clinical outcomes compared to medical doctor (MD)-assigned patients. DATA SOURCES:Veterans Affairs (VA) administrative data capturing characteristics, outcomes, and provider assignments of 806 434 VA...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13246
更新日期：2020-04-01 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:Examine the endogenous relationship between uncompensated care and hospital patient experience scores. DATA SOURCES/STUDY SETTING:The Hospital Consumer Assessment of Healthcare Providers and Systems Survey, CMS Healthcare Cost Report Information System, and the US Census Bureau. STUDY DESIGN:The exogenous c...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13111
更新日期：2019-06-01 00:00:00
abstract：OBJECTIVE:Apply quantile regression for a high-resolution analysis of changes in wait time to treatment and assess its applicability to quality improvement data compared with least-squares regression. DATA SOURCE:Addiction treatment programs participating in the Network for the Improvement of Addiction Treatment. MET...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2012.01436.x
更新日期：2013-02-01 00:00:00
abstract：OBJECTIVE:To construct a data tool, the Residential History File (RHF), that summarizes information from Medicare claims and nursing home (NH) Minimum Data Set (MDS) assessments to track people through health care locations, including non-Medicare-paid NH stays. DATA SOURCES:Online Survey of Certification and Reportin...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01194.x
更新日期：2011-02-01 00:00:00
abstract：:Does a prepaid group practice relative to comparable fee-for-service plans lead to different mental health outcomes for its beneficiaries? To answer this question, we used data from the RAND Health Insurance Experiment. We observed no statistically significant or clinically meaningful differences in mental health outc...
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：1990-10-01 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：:Cost-benefit analyses are routinely included in evaluations of acute care programs. In the case of long-term care, it is frequently alleged that cost-benefit analysis cannot be fruitfully applied. This article demonstrates the utility of applying cost-benefit analysis to evaluations of long-term care programs. A case ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1981-04-01 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 patient loyalty to providers over time, informing effective population health management. STUDY SETTING:Patient care-seeking patterns over a 6-year timeframe in Minnesota, where care systems have a significant portion of their revenue generated by shared-saving contracts with public and private...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12147
更新日期：2014-06-01 00:00:00
