Diagnostic tests and neurology care for Medicare beneficiaries with seizures: differences across racial groups.

Abstract:

BACKGROUND:Seizures and epilepsy are common in older adults especially in some minorities. Despite the importance of medical care to maximize seizure control, little is known about its quality across racial groups. One indicator of quality care is the receipt of electroencephalograms (EEG), and magnetic resonance imaging (MRIs) or computer tomography scans (CTs) after a first seizure. Neurologists' care is also important, given associated diagnosis and treatment challenges in older patients. OBJECTIVE:To examine seizure-related care in the year after a first seizure for Medicare beneficiaries by race. RESEARCH DESIGN:Retrospective administrative claims analysis for 186,547 beneficiaries with claims for seizure or epilepsy in 2003-2005. Logistic regressions determined the association between care and race (White, Asian, African and Native Americans) adjusting for beneficiary, seizure, and community factors. MEASURES:EEGs, CTs or MRIs, and neurology visits. RESULTS:About 60% received EEGs, 80% had MRIs or CT scans, and only 55.9% had an EEG and CT scan or an MRI. CT use (74%) was higher than MRI use (41%). About 79% had neurology visits. Compared with Whites, Native Americans were less likely to have neurology visits (66.9% vs. 78.8%; adjusted odds ratio: 0.72; 95% CI, 0.55-0.92). No clinically significant differences (>5%) were found for care received by other minorities compared with Whites. CONCLUSIONS:Medicare beneficiaries with new-onset seizures commonly visit a neurologist, with some groups lagging behind. Use of some diagnostic tests is less common. Studies should continue investigating the quality of medical care for older adults with seizures.

journal_name

Med Care

journal_title

Medical care

authors

Pisu M,Richman JS,Martin RC,Kim Y,Kratt P,Clements K,Funkhouser E,Knowlton R,Faught E

doi

10.1097/MLR.0b013e31824ebdc4

subject

Has Abstract

pub_date

2012-08-01 00:00:00

pages

730-6

issue

8

eissn

0025-7079

issn

1537-1948

pii

00005650-201208000-00016

journal_volume

50

pub_type

杂志文章
  • Completeness of information on adjuvant therapies for colorectal cancer in population-based cancer registries.

    abstract:BACKGROUND:Population-based cancer registries represent a potentially valuable tool to evaluate treatment; however, information on the completeness of registry treatment data is sparse. OBJECTIVE:To evaluate the completeness of registry treatment data for patients with colorectal cancer and to identify predictors of c...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.MLR.0000083740.12949.88

    authors: Cress RD,Zaslavsky AM,West DW,Wolf RE,Felter MC,Ayanian JZ

    更新日期:2003-09-01 00:00:00

  • Consumer Use of Provider Quality Report Cards: The Role of Dissemination and Media Coverage.

    abstract:OBJECTIVE:The objective of this study was to measure the dissemination of comparative provider quality information (CPQI) and evaluate its impact on consumers' awareness and use of CPQI. DATA SOURCES:Two-period, random-digit-dial panel survey of chronically ill consumers residing in 14 regions of the United States; su...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001279

    authors: Bhandari N,Scanlon DP,Shi Y,Smith RA

    更新日期:2020-04-01 00:00:00

  • Mortality Associated With Emergency Department Boarding Exposure: Are There Differences Between Patients Admitted to ICU and Non-ICU Settings?

    abstract:BACKGROUND:Emergency Department (ED) boarding threatens patient safety. It is unclear whether boarding differentially affects patients admitted to intensive care units (ICUs) versus non-ICU settings. RESEARCH DESIGN AND SUBJECTS:We performed a 2-hospital, 18-month, cross-sectional, observational, descriptive study of ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000902

    authors: Reznek MA,Upatising B,Kennedy SJ,Durham NT,Forster RM,Michael SS

    更新日期:2018-05-01 00:00:00

  • Determinants of the quality of restorative dental care.

    abstract::This article reports the results of an analysis to determine the relationships between the quality of restorative dental care for 1,466 patients and 9 categories of dentist characteristics for 102 volunteer Washington practitioners. In this study, patients were recalled and restorations were examined clinically. Quest...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198004000-00005

    authors: Milgrom P,Ratener P,Conrad D,Weinstein P

    更新日期:1980-04-01 00:00:00

  • Physician gender effects on preventive screening and counseling: an analysis of male and female patients' health care experiences.

    abstract:BACKGROUND:Studies have documented that patients of female physicians receive higher levels of preventive services. However, most studies include patients of only one gender, examine mainly gender-specific screening services, and do not examine patient education and counseling. OBJECTIVES:This study tests both physici...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-200112000-00004

    authors: Henderson JT,Weisman CS

    更新日期:2001-12-01 00:00:00

  • The effect of improving primary care depression management on employee absenteeism and productivity. A randomized trial.

    abstract:OBJECTIVE:To test whether an intervention to improve primary care depression management significantly improves productivity at work and absenteeism over 2 years. SETTING AND SUBJECTS:Twelve community primary care practices recruiting depressed primary care patients identified in a previsit screening. RESEARCH DESIGN:...

    journal_title:Medical care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00005650-200412000-00007

    authors: Rost K,Smith JL,Dickinson M

    更新日期:2004-12-01 00:00:00

  • A Decade in Review: Cancer Care Ontario's Approach to Symptom Assessment and Management.

    abstract:BACKGROUND:In 2007 Cancer Care Ontario (CCO) implemented standardized systematic symptom evaluation in all cancer patients in Ontario using the Edmonton Symptom Assessment System. The initial implementation did not include symptom management guidance and this limited the success of the implementation. Within a short ti...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001084

    authors: Barbera L,Moody L

    更新日期:2019-05-01 00:00:00

  • Overall quality of life and difficulty paying for ostomy supplies in the Veterans Affairs ostomy health-related quality of life study: an exploratory analysis.

    abstract:PURPOSE:To explore whether there was a significant relationship between difficulty paying for ostomy supplies and overall quality of life among a sample of ostomates receiving care from the Veterans Health Administration (VHA). METHODS:The data were collected as part of the Veterans Affairs (VA) Ostomy Health-Related ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e318074ce9b

    authors: Coons SJ,Chongpison Y,Wendel CS,Grant M,Krouse RS

    更新日期:2007-09-01 00:00:00

  • Sequelae of an Evidence-based Approach to Management for Access to Care in the Veterans Health Administration.

    abstract:BACKGROUND:Access to health care is a critical concept in the design, delivery, and evaluation of high quality care. Meaningful evaluation of access requires research evidence and the integration of perspectives of patients, providers, and administrators. OBJECTIVE:Because of high-profile access challenges, the Depart...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001177

    authors: Kaboli PJ,Miake-Lye IM,Ruser C,Yano EM,Orshansky G,Rubenstein L,Curtis I,Kirsh S,Hempel S

    更新日期:2019-10-01 00:00:00

  • Measuring physician job satisfaction in a changing workplace and a challenging environment. SGIM Career Satisfaction Study Group. Society of General Internal Medicine.

    abstract:BACKGROUND:Changes in the demographic, specialty, and employment sector composition of medicine have altered physicians' jobs, limiting autonomy and reducing morale. Because physician job satisfaction has been linked to clinical variables, better measurement might help to ameliorate conditions linked to medical disaffe...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199911000-00010

    authors: Konrad TR,Williams ES,Linzer M,McMurray J,Pathman DE,Gerrity M,Schwartz MD,Scheckler WE,Van Kirk J,Rhodes E,Douglas J

    更新日期:1999-11-01 00:00:00

  • Associations between health status and utilities implications for policy.

    abstract:BACKGROUND:If shape of a person's utility function is associated with his health status, as is predicted by Prospect Theory, the use of utilities from the healthy could result in 'de facto' discrimination against the sick. OBJECTIVES:To determine if patients' utilities for hypothetical states and for their current hea...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199905000-00007

    authors: Lenert LA,Treadwell JR,Schwartz CE

    更新日期:1999-05-01 00:00:00

  • Consumerism in health care. Prevalence and predictors.

    abstract::Current efforts to contain health care costs include a variety of strategies aimed at the users of health services. These approaches attempt to encourage users to be more cost-conscious and to shop for lower-cost services and more efficient health care plans. The primary method for achieving this is by increasing the ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198711000-00001

    authors: Hibbard JH,Weeks EC

    更新日期:1987-11-01 00:00:00

  • An index of insurance adequacy for fertility-related health care.

    abstract::Health insurance plans are evaluated here in terms of ability to guarantee financial access to a set of basic fertility-related health services. Extent of coverage is determined by whether a service is a contract benefit, its market cost, and how often it is used in a given population in one year. Comprehensive covera...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-197501000-00003

    authors: Muller C,Krasner M,Jaffe FS

    更新日期:1975-01-01 00:00:00

  • Changes in the costs of treatment of selected illnesses, 1971-1981.

    abstract::This study, like two earlier studies by the author, examines the effects of changing medical technologies on medical care costs by comparing the costs of treatment of a number of common illnesses at two points in time, 1971 and 1981. While the earlier studies, covering the periods 1951-1964 and 1964-1971, showed that ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198512000-00004

    authors: Scitovsky AA

    更新日期:1985-12-01 00:00:00

  • Association of Federal Mental Health Parity Legislation With Health Care Use and Spending Among High Utilizers of Services.

    abstract:BACKGROUND:Decades-long efforts to require parity between behavioral and physical health insurance coverage culminated in the comprehensive federal Mental Health Parity and Addiction Equity Act. OBJECTIVES:To determine the association between federal parity and changes in mental health care utilization and spending, p...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001076

    authors: Haffajee RL,Mello MM,Zhang F,Busch AB,Zaslavsky AM,Wharam JF

    更新日期:2019-04-01 00:00:00

  • Administrative hospitalization database validation of cardiac procedure codes.

    abstract:BACKGROUND:Although cardiac procedures are commonly used to treat cardiovascular disease, they are costly. Administrative data sources could be used to track cardiac procedures, but sources of such data have not been validated against clinical registries. OBJECTIVES:To examine accuracy of cardiac procedure coding in a...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e3182329778

    authors: Lee DS,Stitt A,Wang X,Yu JS,Gurevich Y,Kingsbury KJ,Austin PC,Tu JV

    更新日期:2013-04-01 00:00:00

  • The role of new health practitioners in a prepaid group practice: provider differences in process and outcomes of medical care.

    abstract::Practice patterns and patient-reported outcomes of care are compared in detail for ten physicians and 12 new health practitioners delivering ambulatory care in two departments of a prepaid group practice, the Columbia Medical Plan (CMP). All providers completed questionnaires for a 50 per cent random sample of patient...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-197604000-00004

    authors: Levine DM,Morlock LL,Mushlin AI,Shapiro S,Malitz FE

    更新日期:1976-04-01 00:00:00

  • Methodological challenges and innovations in patient outcomes research.

    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:

    authors: Maklan CW,Greene R,Cummings MA

    更新日期:1994-07-01 00:00:00

  • The Self-Adapting Focused Review System. Probability sampling of medical records to monitor utilization and quality of care.

    abstract::Medical record review is increasing in importance as the need to identify and monitor utilization and quality of care problems grow. To conserve resources, reviews are usually performed on a subset of cases. If judgment is used to identify subgroups for review, this raises the following questions: How should subgroups...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:

    authors: Ash A,Schwartz M,Payne SM,Restuccia JD

    更新日期:1990-11-01 00:00:00

  • Encouraging behavior changes by use of client-held health records.

    abstract::A process was developed to encourage individuals to take more responsibility for their health by using a client-held health record. The motivation for the record, called a Personal Life Health Plan (PLHP), stems from the fact that the majority of ills which afflict an individual can be abated by behavior changes. The ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-197809000-00006

    authors: Giglio R,Spears B,Rumpf D,Eddy N

    更新日期:1978-09-01 00:00:00

  • A cost-effectiveness analysis of amniocentesis and chorionic villus sampling for prenatal genetic testing.

    abstract::Amniocentesis and chorionic villus sampling are tests for the prenatal diagnosis of cytogenetic abnormalities. We calculated the incremental costs per abnormal birth averted, and the incremental costs per quality-adjusted outcome, of amniocentesis and chorionic villus sampling performed for the indication of maternal ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199408000-00008

    authors: Heckerling PS,Verp MS

    更新日期:1994-08-01 00:00:00

  • Impact of a high-deductible health plan on outpatient visits and associated diagnostic tests.

    abstract:BACKGROUND:By shifting a greater share of out-of-pocket medical costs to consumers, high-deductible health plans (HDHP) might discourage use of essential outpatient services. OBJECTIVE:The objective of the study was to examine the impact of an HDHP on outpatient visits and associated laboratory and radiology tests. R...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000008

    authors: Reddy SR,Ross-Degnan D,Zaslavsky AM,Soumerai SB,Wharam JF

    更新日期:2014-01-01 00:00:00

  • Satisfaction, gender, and communication in medical visits.

    abstract::The authors conducted two studies of routine medical visits, investigating the relation of physician gender, patient gender, and physician age to patient satisfaction, and the correlations between communication behaviors and satisfaction separately for different combinations of patient and physician gender. Study 1 wa...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199412000-00005

    authors: Hall JA,Irish JT,Roter DL,Ehrlich CM,Miller LH

    更新日期:1994-12-01 00:00:00

  • Examining Measures of Income and Poverty in Medicare Administrative Data.

    abstract::Disparities by economic status are observed in the health status and health outcomes of Medicare beneficiaries. For health services and health policy researchers, one barrier to addressing these disparities is the ability to use Medicare data to ascertain information about an individual's income level or poverty, beca...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000606

    authors: Samson LW,Finegold K,Ahmed A,Jensen M,Filice CE,Joynt KE

    更新日期:2017-12-01 00:00:00

  • Out-of-pocket health spending between low-and higher-income populations: who is at risk of having high expenses and high burdens?

    abstract:OBJECTIVE:We studied the effects of health insurance, health care needs, and demographic and area characteristics on out-of-pocket health care spending for low and higher income insured populations. MATERIALS AND METHODS:We used the 2002 National Survey of America's Families to analyze out-of-pocket health spending. P...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000199692.78295.7c

    authors: Shen YC,McFeeters J

    更新日期:2006-03-01 00:00:00

  • When does an episode of care for cancer begin?

    abstract:BACKGROUND:Little is known about the medical care resources devoted to diagnosing and treating cancer-related symptoms before a definitive cancer diagnosis. Previous research using SEER-Medicare data to measure incremental costs and utilization associated with cancer started with the date of diagnosis. We hypothesized ...

    journal_title:Medical care

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/MLR.0b013e3182731277

    authors: Hornbrook MC,Fishman PA,Ritzwoller DP,Elston-Lafata J,O'Keeffe-Rosetti MC,Salloum RG

    更新日期:2013-04-01 00:00:00

  • Psychiatric severity of illness. A case mix study.

    abstract::This study was undertaken to determine if a measure of severity of illness for psychiatric patients, the Psychiatric Severity of Illness Index, could produce psychiatric case mix groups that are more homogeneous with respect to resource use than the diagnosis-related groups (DRGs). Psychiatric Severity of Illness data...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198901000-00007

    authors: Horn SD,Chambers AF,Sharkey PD,Horn RA

    更新日期:1989-01-01 00:00:00

  • Patient complexity and risk factor control among multimorbid patients with type 2 diabetes: results from the R2D2C2 study.

    abstract:BACKGROUND:Among patients with type 2 diabetes, it is not known whether risk factor control is better or worse for those who also have heart disease, depression, multiple other comorbidities, and associated management challenges. OBJECTIVE:To examine the relationship between this complex constellation of multimorbidit...

    journal_title:Medical care

    pub_type: 杂志文章,多中心研究

    doi:10.1097/MLR.0b013e318273119b

    authors: Malik S,Billimek J,Greenfield S,Sorkin DH,Ngo-Metzger Q,Kaplan SH

    更新日期:2013-02-01 00:00:00

  • The lifetime cost of current human immunodeficiency virus care in the United States.

    abstract:OBJECTIVE:We sought to project the lifetime cost of medical care for human immunodefiency virus (HIV)-infected adults using current antiretroviral therapy (ART) standards. METHODS:Medical visits and hospitalizations for any reason were from the HIV Research Network, a consortium of high-volume HIV primary care sites. ...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.mlr.0000228021.89490.2a

    authors: Schackman BR,Gebo KA,Walensky RP,Losina E,Muccio T,Sax PE,Weinstein MC,Seage GR 3rd,Moore RD,Freedberg KA

    更新日期:2006-11-01 00:00:00

  • Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact.

    abstract:OBJECTIVES:This study proposes methods for blending design components of clinical effectiveness and implementation research. Such blending can provide benefits over pursuing these lines of research independently; for example, more rapid translational gains, more effective implementation strategies, and more useful info...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e3182408812

    authors: Curran GM,Bauer M,Mittman B,Pyne JM,Stetler C

    更新日期:2012-03-01 00:00:00