Abstract:
BACKGROUND:Federal, state, and local governments provide substantial subsidies to so-called "safety-net" hospitals, in part, to offset the loss in revenue associated with providing a disproportionate share (DSH) of care to low-income and uninsured patients, with the goal to improve access to care for uninsured and ensure affordable care for them. OBJECTIVES:We investigate the targeting of DSH subsidies and their impact on pricing to uninsured patients in acute care for-profit and nonprofit hospitals. METHODS:The study sample includes all California acute care private hospitals that report comparable financial data to the State and covers 2001 through 2006 time period. Relative price to uninsured is measured as the percent difference of uninsured payments from Medicare payments, by comparing percent of charges paid by uninsured as a group to percent of charges paid by Medicare within each hospital. RESULTS:Sixty-five percent of all uninsured care among private hospitals is provided by nonprofit hospitals that are non-DSH. Although, uninsured patients still pay lower prices at DSH hospitals compared with non-DSH hospitals of the same ownership category, this difference reduced substantially over time. For-profit DSH hospitals serve a smaller share of uninsured patients and charge higher uninsured prices than nonprofit non-DSH hospitals but receive the highest DSH subsidy as a percent of their revenues. CONCLUSIONS:In California, DSH subsidies do not target highest providers of care to uninsured and in 2005-2006 have had very small potential as a mechanism of reducing prices to uninsured.
journal_name
Med Carejournal_title
Medical careauthors
Fonkych K,Melnick Gdoi
10.1097/MLR.0b013e3181e3572csubject
Has Abstractpub_date
2010-09-01 00:00:00pages
809-14issue
9eissn
0025-7079issn
1537-1948journal_volume
48pub_type
杂志文章相关文献
MEDICAL CARE文献大全abstract::Between 1989 and 1992, the Agency for Health Care Policy and Research (AHCPR) awarded funding to 14 special projects known as Patient Outcomes Research Teams (PORTs). These large, complex projects form the centerpiece of the first generation of research under the Medical Treatment Effectiveness Program. In carrying ou...
journal_title:Medical care
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVES:The purpose of this review is to identify and analyze published studies that have evaluated disparities for opportunistic infection (OI) prophylaxis between blacks and whites with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in the United States. METHODS:The authors conducted...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/MLR.0b013e31826c85d1
更新日期:2012-11-01 00:00:00
abstract::The purpose of this paper is to provide a systematic explanation of the use of traditional medicine among the native American population living in the San Francisco Bay area. Several hypotheses concerning the factors associated with this behavior are tested. These include tribal grouping, socioeconomic and sociocultur...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197511000-00004
更新日期:1975-11-01 00:00:00
abstract::The cost of obstetric care delivered in a cooperative care unit was compared with the cost for similar patients treated in a traditional inpatient maternity unit. The study sample contained 1,683 consecutive patients representing 23 diagnosis categories. The analysis indicates that cooperative care patients had signif...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198806000-00008
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:Performance assessments help to quantify the level of adherence with practice standards and are often used to measure and compare the quality of care. However, most performance assessments are based on a cross-sectional analysis of patient information, whereas patient care is inherently longitudinal. This di...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000109167.86509.24
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Clinical practice guidelines quickly become outdated. One reason they might not be updated as often as needed is the expense of collecting expert judgment regarding the evidence. The RAND-UCLA Appropriateness Method is one commonly used method for collecting expert opinion. We tested whether a less expensive...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.MLR.0000100583.76137.3E
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:Measures for pay-for-performance and public reporting programs may be based on clinical practice guidelines. The impact of guideline changes over time-and whether evolving clinical evidence can render measures based on prior guidelines misleading-is not known. OBJECTIVE:To assess the impact of using differe...
journal_title:Medical care
pub_type: 杂志文章,多中心研究
doi:10.1097/MLR.0b013e3181e35b3a
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Providing collaborative mental health treatment within primary care settings improves depression outcomes and may improve detection of mental disorders. Few studies have assessed the effect of collaborative mental health treatment programs on diagnosis of mental disorders in primary care populations. In 2008...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181e5792b
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:The quality of care for Medicare beneficiaries with diabetes remains suboptimal. The contributing factors at the physician level are not well characterized, especially the relationship of patient volume and physician performance. OBJECTIVE:We sought to determine associations between the number of Medicare d...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000233685.22497.cf
更新日期:2006-12-01 00:00:00
abstract::Our purpose was to identify factors predictive of reported dental care use by elders (65+) over a ten-year period in Massachusetts. The Massachusetts Health Care Panel Study began in 1974-75 (wave 1) as a statewide survey of 1625 noninstitutionalized elders. Wave 2 occurred in 1976, wave 3 in 1980, and wave 4 in 1985....
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199012000-00005
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:The 3 primary administrative data sets developed by the Centers for Medicare and Medicaid services (CMS) to support the Medicare Part D program implementation represent a valuable source of data for health services researchers. This paper describes the structure of the Medicare Part D program and the related...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318041385f
更新日期:2007-10-01 00:00:00
abstract::This article emphasizes the advantages and disadvantages of the National Center for Health Statistics Health Interview Surveys (HIS) when applied to the needs of ethnic minorities at the local level. While HIS gives information on health status of minorities and their use of services at the national level, this inform...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198003000-00006
更新日期:1980-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to identify hospital organizational characteristics consistently associated with adherence to multiple clinical practice guidelines (CPGs). We examined the relationship between organizational and patient population characteristics and adherence to three screening CPGs implemented...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-200212000-00005
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Previous studies of nonresponders have not assessed the effects of nonresponse on the accuracy of clinician behavior measurements. Knowledge of these effects is critical to both research and quality improvement. OBJECTIVE:To evaluate the hypothesis that nonresponders to a survey would not adversely affect t...
journal_title:Medical care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005650-200204000-00010
更新日期:2002-04-01 00:00:00
abstract:INTRODUCTION:Screening hospital patients for falls risk is now a contentious component of geriatric care despite its widespread clinical use. The economic implications of using a falls risk screening approach to deliver an effective falls prevention intervention have not previously been examined. METHODS:This was a mu...
journal_title:Medical care
pub_type: 杂志文章,多中心研究
doi:10.1097/MLR.0b013e318190ccc0
更新日期:2009-04-01 00:00:00
abstract::To test the hypothesis that the ability of physicians to speak the same language as asthmatic patients promotes patient compliance and the use of scheduled office appointments in preference to emergency services, the charts of 96 Spanish-speaking patients with asthma were reviewed. Of these patients, 65 were cared for...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198812000-00003
更新日期:1988-12-01 00:00:00
abstract::Effective physician involvement in quality assurance in hospitals is necessary both to identify problems in patient care and to bring about problem resolution. This report describes a controlled, longitudinal study designed to measure effects on physician performance of involving physicians in setting medical audit cr...
journal_title:Medical care
pub_type: 临床试验,杂志文章
doi:10.1097/00005650-198412000-00006
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:Services targeting social determinants of health-such as income support, housing, and nutrition-have been shown to improve health outcomes and reduce health care costs for older adults. Nevertheless, evidence on the properties of effective collaborative networks across health care and social services sectors...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001097
更新日期:2019-05-01 00:00:00
abstract::The authors compared the continuity of care that family physicians, general internists, and medical subspecialists provided to their adult primary care patients. The 40 study physicians came from large, private multispecialty practices in the San Francisco Bay Area. The three physician types did not differ significant...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198501000-00007
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:Investigators have used a variety of operational definitions of nursing hours of care in measuring nurse staffing for health services research. However, little is known about which approach is best for nurse staffing measurement. OBJECTIVE:To examine whether various nursing hours measures yield different mo...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e318277eb50
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Opioid use disorders are frequently associated with medical and psychiatric comorbidities (eg, HIV infection and depression), as well as social problems (eg, lack of health insurance). Comprehensive services addressing these conditions improve outcomes. OBJECTIVE:To compare the proportion of for-profit, non...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000121
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:One approach postulated to improve the provision of health care is effective utilization of team-based care including pharmacists. OBJECTIVE:The objective of this study was to conduct a comprehensive systematic review with focused meta-analyses to examine the effects of pharmacist-provided direct patient ca...
journal_title:Medical care
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MLR.0b013e3181e57962
更新日期:2010-10-01 00:00:00
abstract::In this study, trends in hospital use were identified in Japanese cities. Data for all inpatient care in May 1985 (9,555 patients) and in May 1988 (11,205 patients) paid for by National Health Insurance in 12 cities in Osaka Prefecture were analyzed. The main factor affecting differences in inpatient days per insured ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199304000-00005
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Methods to select physicians most likely to benefit from educational interventions to improve the outcome of depression have not been adequately developed. OBJECTIVE:The purpose of this study was to identify a combination of primary care provider (PCP) self-report questions to improve the precision of PCP e...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-200007000-00009
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Indwelling urinary catheters are used postoperatively in hip fracture care. Their use beyond the immediate postoperative period may result in excess nosocomial infections. OBJECTIVES:The objectives of this study were to explore the relationship between extended indwelling urinary catheterization and outcome...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000178199.07789.32
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:The Program of All-Inclusive Care for the Elderly (PACE) is an acute/long-term managed care plan designed to care for the most frail and vulnerable Medicare beneficiaries. To our knowledge, this is a first study to examine patterns and predictors of disenrollment from PACE. OBJECTIVE:PACE, with its comprehe...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000188920.19129.89
更新日期:2006-01-01 00:00:00
abstract::This article is an analysis of patient choice of providers by the employees of the Security Pacific Bank of California and their dependents who have access to the Med Network Preferred Provider Organization (PPO). The empirical results show that not only is the PPO used by individuals who require relatively little med...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198803000-00002
更新日期:1988-03-01 00:00:00
abstract::Issues that arise in the development of methods for measuring adequacy of physician performance (MAPP) are discussed. The comparative content validity, scorability, cost, and acceptability of four MAPP strategies are assessed using a sample of clinic-based physicians treating 30 patients with chronic obstructive pulmo...
journal_title:Medical care
pub_type: 临床试验,杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract::A prospective study was undertaken to characterize 2,000 patients attending a chiropractic teaching clinic and the effectiveness of the care they received. Fifty-two percent of the patients were between 21 and 34 years old; 41% categorized their occupation as professional and 14% as skilled blue collar; 79% presented ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198706000-00006
更新日期:1987-06-01 00:00:00
abstract:BACKGROUND:Assessing accuracy and completeness of data is an important component of conducting research. VA Healthcare System benefits from a highly developed electronic medical information system. The Immunology Case Registry was designed to monitor costs and quality of HIV care. The Decision Support System was develo...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31817d69c2
更新日期:2009-01-01 00:00:00