Abstract:
OBJECTIVE:To compare safety climate between diverse U.S. hospitals and Veterans Health Administration (VA) hospitals, and to explore the factors influencing climate in each setting. DATA SOURCES:Primary data from surveys of hospital personnel; secondary data from the American Hospital Association's 2004 Annual Survey of Hospitals. STUDY DESIGN:Cross-sectional study of 69 U.S. and 30 VA hospitals. DATA COLLECTION:For each sample, hierarchical linear models used safety-climate scores as the dependent variable and respondent and facility characteristics as independent variables. Regression-based Oaxaca-Blinder decomposition examined differences in effects of model characteristics on safety climate between the U.S. and VA samples. PRINCIPAL FINDINGS:The range in safety climate among U.S. and VA hospitals overlapped substantially. Characteristics of individuals influenced safety climate consistently across settings. Working in southern and urban facilities corresponded with worse safety climate among VA employees and better safety climate in the U.S. sample. Decomposition results predicted 1.4 percentage points better safety climate in U.S. than in VA hospitals: -0.77 attributable to sample-characteristic differences and 2.2 due to differential effects of sample characteristics. CONCLUSIONS:Results suggest that safety climate is linked more to efforts of individual hospitals than to participation in a nationally integrated system or measured characteristics of workers and facilities.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Singer SJ,Hartmann CW,Hanchate A,Zhao S,Meterko M,Shokeen P,Lin S,Gaba DM,Rosen AKdoi
10.1111/j.1475-6773.2009.00994.xsubject
Has Abstractpub_date
2009-10-01 00:00:00pages
1563-83issue
5 Pt 1eissn
0017-9124issn
1475-6773pii
HESR994journal_volume
44pub_type
杂志文章abstract:OBJECTIVE:Building on the original taxonomy of hospital-based health systems from 20 years ago, we develop a new taxonomy to inform emerging public policy and practice developments. DATA SOURCES:The 2016 American Hospital Association's (AHA) Annual Survey; the 2016 IQVIA Healthcare Organizations and Systems (HCOS) dat...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13621
更新日期:2021-01-11 00:00:00
abstract:OBJECTIVE:The case mix-adjusted pattern of use of health care services, especially posthospital care, is compared before and after the introduction of Medicare's Prospective Payment System (PPS). DATA SOURCES:The 1982 and 1984 National Long Term Care Surveys (NLTCS) linked to Medicare administrative records 1982-1986 ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1993-08-01 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:OBJECTIVES:To provide updated estimates of narrow- and broad-spectrum antibiotic use among U.S. children. DATA SOURCES:Linked nationally representative data from the 2004-2010 Medical Expenditure Panel Survey Household Component and the 2000 Decennial Census. STUDY DESIGN:Relationships between individual-, family-, a...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12260
更新日期:2015-06-01 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:OBJECTIVE:To examine financial and nonfinancial access to care and utilization of primary health care services among children of working low-income families earning below 200 percent of the federal poverty level in California, and to compare them to children in nonworking low-income families and in families earning ove...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:To test the effects of state prescription contraception insurance mandates on unintended, mistimed, and unwanted births in a sample of privately insured recent mothers. DATA:We pooled Pregnancy Risk Assessment Monitoring System (PRAMS) data from 1997 to 2012 to study 209,964 privately insured recent mothers ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12792
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To measure the association between clinician specialization in nursing home (NH) practice and outcomes of patients who received postacute care in skilled nursing facilities (SNFs). DATA SOURCES:Medicare claims and NH assessments for 2 118 941 hospital discharges to 14 526 SNFs in January 2012-October 2014 an...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13138
更新日期:2019-06-01 00:00:00
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 differenc...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00601.x
更新日期:2007-02-01 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 the impact of mandatory HMO enrollment for Medicaid-covered pregnant women on prenatal care use, smoking, Cesarean section (C-section) use, and birth weight. DATA SOURCES/STUDY SETTING:Linked birth certificate and Medicaid enrollment data from July 1993 to June 1998 in 10 Ohio counties, 6 that imp...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00260.x
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of a locally adapted evidence-based quality improvement (EBQI) approach to implementation of smoking cessation guidelines into routine practice. DATA SOURCES/STUDY SETTING:We used patient questionnaires, practice surveys, and administrative data in Veterans Health Administration (VA) p...
journal_title:Health services research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1475-6773.2008.00865.x
更新日期:2008-10-01 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::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 estimate 2012 tax expenditures for employer-sponsored insurance (ESI) in the United States and to explore the sensitivity of estimates to assumptions regarding the incidence of employer premium contributions. DATA SOURCES:Nationally representative Medical Expenditure Panel Survey data from the 2005-2007 H...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12037
更新日期:2013-04-01 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:OBJECTIVE:To examine the predictors of unit and item nonresponse, the magnitude of nonresponse bias, and the need for nonresponse weights in the Consumer Assessment of Health Care Providers and Systems (CAHPS) Hospital Survey. METHODS:A common set of 11 administrative variables (41 degrees of freedom) was used to pred...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00476.x
更新日期:2005-12-01 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 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 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:BACKGROUND:In 2004, the State of Wisconsin introduced a change to their Medicaid Policy allowing medical care providers to be reimbursed for fluoride varnish treatment provided to Medicaid enrolled children. OBJECTIVE:To determine the extent by which a state-level policy change impacted access to fluoride varnish trea...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.00975.x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:This study evaluates the relationship between hospital and regional characteristics and the prevalence of mobile computed tomography in rural hospitals. DATA SOURCES AND STUDY SETTING:Primary data were gathered from all rural hospitals in eight northwestern states (n = 471) in 1991. Secondary data sources in...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:To provide guidance on improving the quality of case studies in health services research. DATA SOURCES:Secondary data, drawing from previous case study research. RESEARCH DESIGN:Guidance is provided to two audiences: potential case study investigators (eight items) and reviewers of case study proposals (fou...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:
更新日期:1999-12-01 00:00:00
abstract::Organizations are increasingly becoming dynamic and unstable. This evolution has given rise to greater reliance on teams and increased complexity in terms of team composition, skills required, and degree of risk involved. High-reliability organizations (HROs) are those that exist in such hazardous environments where t...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00566.x
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:To assess the impact of substance abuse claims redaction on Medicare spending estimates for beneficiaries with serious mental illness. DATA SOURCES:The 2012 claims and unredacted beneficiary-level Medicare spending totals from CMS's Chronic Conditions Warehouse. STUDY DESIGN:We identified beneficiaries with...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12528
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:To assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. DATA SOURCES/STUDY SETTING:Existing liter...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:10.1111/1475-6773.12420
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the prevalence of seven social factors using physician notes as compared to claims and structured electronic health records (EHRs) data and the resulting association with 30-day readmissions. STUDY SETTING:A multihospital academic health system in southeastern Massachusetts. STUDY DESIGN:An obse...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12670
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To assess the extent and consistency of geographic differences in the use of post-acute care (PAC), and the stability of this pattern of variation. DATA SOURCES:The 5 percent Medicare data sample for 1996, 1997, and the first eight months of 1998 were used. STUDY DESIGN:Patterns of PAC use for various Diagn...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00043
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:To examine reported experiences of gender discrimination and harassment among US women. DATA SOURCE AND STUDY DESIGN:Data come from a nationally representative, probability-based telephone survey of 1596 women, conducted January-April 2017. METHODS:We calculated the percentages of women reporting gender dis...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13217
更新日期:2019-12-01 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