Abstract：
OBJECTIVE:To examine factors associated with guideline-concordant adjuvant therapy among breast cancer patients in a rural region of the United States and to present an advancement in quality-of-care assessment in the context of multiple treatments. DATA SOURCES:Chart abstraction on initial therapy received by 868 women diagnosed with primary, invasive, early-stage breast cancer in a largely rural region of southwest Georgia. STUDY DESIGN:Using multivariable logistic regression, we examined predictors of adjuvant chemo-, radiation, and hormonal therapy regimens defined as guideline-concordant according to the 2000 National Institutes of Health Consensus Development Conference Statement. PRINCIPAL FINDINGS:Overall, 35.2 percent of women received guideline-concordant care for all three adjuvant therapies. Higher socioeconomic status was associated with receiving guideline-concordant care for all three adjuvant therapies jointly, and for chemotherapy. Compared with private insurance, having Medicaid was associated with guideline-concordant chemotherapy. Unmarried women were more likely to be nonconcordant for chemotherapy and radiation therapy. Increased age predicted nonconcordance for adjuvant therapies jointly, for chemotherapy, and for hormonal therapy. CONCLUSIONS:A number of factors were independently associated with receiving guideline-concordant adjuvant therapy. Identifying and addressing factors that lead to nonconcordance may reduce disparities in treatment and survival.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Guy GP Jr,Lipscomb J,Gillespie TW,Goodman M,Richardson LC,Ward KCdoi
10.1111/1475-6773.12269subject
Has Abstractpub_date
2015-08-01 00:00:00pages
1088-108issue
4eissn
0017-9124issn
1475-6773journal_volume
50pub_type
杂志文章abstract：OBJECTIVE:To determine how the addition of generalist care managers and collaborative information technology to an ambulatory team affects the care of patients with diabetes. STUDY SETTING:Multiple ambulatory clinics within Intermountain Health Care (IHC), a large integrated delivery network. STUDY DESIGN:A retrospec...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2005.00423.x
更新日期：2005-10-01 00:00:00
abstract：OBJECTIVE:To explore and understand approaches to user engagement through investigating the range of ways in which health care workers and organizations accommodated the introduction of computerized physician order entry (CPOE) and computerized decision support (CDS) for hospital prescribing. STUDY SETTING:Six hospita...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12581
更新日期：2017-10-01 00:00:00
abstract：OBJECTIVE:Examine the impact of the 2011 shortage of the drug cytarabine on patient receipt and timeliness of induction treatment for Acute Myeloid Leukemia (AML). STUDY DESIGN:A retrospective cohort was utilized to examine odds of receipt of inpatient induction chemotherapy and time to first dose across major (N = 10...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13028
更新日期：2018-12-01 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 compare estimates of health coverage from the pre- and post- redesign of the Current Population Survey (CPS) Annual Social and Economic Supplement. DATA SOURCES/STUDY SETTING:The CPS 2013 Content Test. STUDY DESIGN:A test of the old and new CPS in which the control panel was a subset of the CPS productio...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12312
更新日期：2016-02-01 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：OBJECTIVE:The purpose of this study is to determine whether women who have been diagnosed with HIV utilize the same volume of medical care services as men who have been diagnosed with HIV. DATA SOURCES:This study uses data from the first wave of interviews of the AIDS Cost and Service Utilization Survey (ACSUS) conduc...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1993-12-01 00:00:00
abstract：OBJECTIVE:To develop a scale to measure patients' trust in health insurers, including public and private insurers and both indemnity and managed care. A scale was developed based on our conceptual model of insurer trust. The scale was analyzed for its factor structure, internal consistency, construct validity, and othe...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2002-02-01 00:00:00
abstract：OBJECTIVE:To determine if the availability of public ambulatory clinics affects preventable hospitalization (PH) rates of low-income and elderly populations. DATA SOURCES:PH rates were calculated using elderly and low-income discharges from 1995-97 Virginia hospital discharge data. Other data sources include the 1990 ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2001-06-01 00:00:00
abstract：OBJECTIVE:To explain the association of out-of-pocket (OOP) cost, community-level factors, and individual characteristics on statin therapy nonadherence. DATA SOURCES:BlueCross BlueShield of Texas claims data for the period of 2008-2011. STUDY DESIGN:A retrospective cohort of 49,176 insured patients, aged 18-64 years...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12547
更新日期：2017-08-01 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 influence of relational climate on quality of diabetes care. DATA SOURCES/STUDY SETTING:The study was conducted at the Department of Veterans Affairs (VA). The VA All Employee Survey (AES) was used to measure relational climate. Patient and facility characteristics were gathered from VA adminis...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12675
更新日期：2018-04-01 00:00:00
abstract：:This article reports an evaluation of the impact of three administrative technologies--Admission Scheduling (AS) Systems, Outpatient Surgery (OPS) Programs, and Preadmission Testing (PAT) Programs--on the number of acute care beds required by a hospital. The evaluation mechanism reported here is called the ADTECH Comp...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1985-04-01 00:00:00
abstract：OBJECTIVE:To examine county-level geographic variation in treatment admissions among opioid treatment programs (OTPs) that accept Medicaid in the continental United States. DATA SOURCES/STUDY SETTING:Data come from the 2012 National Survey of Substance Abuse Treatment Services. STUDY DESIGN/DATA COLLECTION:We used lo...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12686
更新日期：2018-02-01 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 determine whether Medicare enrollment at age 65 has an effect on the health trajectory of the near-elderly uninsured. DATA SOURCES:Eight biennial waves (1992-2006) of the Health and Retirement Study, a nationally representative panel survey of noninstitutionalized 51-61 year olds and their spouses. STUDY...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2009.00964.x
更新日期：2009-06-01 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：RESEARCH OBJECTIVE:To investigate disenrollment from public insurance at the 6-year transitional birthday when eligibility for many children moves from Medicaid to State Children's Health Insurance Program (S-CHIP). DATA SOURCES:Data from Georgia's S-CHIP (PeachCare) and Medicaid programs from 2000 to 2002. STUDY DES...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00795.x
更新日期：2007-12-01 00:00:00
abstract：BACKGROUND:The use of Medicaid data to study cancer-related outcomes would be highly desirable. However, the accuracy of Medicaid claims data in the identification of incident cases of breast cancer is unknown. OBJECTIVES:(1) To estimate the sensitivity of Medicaid claims data for case ascertainment of breast cancer, ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.00155
更新日期：2003-06-01 00:00:00
abstract：OBJECTIVE:To determine the extent to which the elimination of behavioral health benefits for selected beneficiaries of Oregon's Medicaid program affected general medical expenditures among enrollees using outpatient mental health and substance abuse treatment services. DATA SOURCE/STUDY SETTING:Twelve months of claims...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2008.00844.x
更新日期：2008-08-01 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 ways in which the costs of nonresidential mental health care depend on (1) the type of provider who initiates the treatment episode and (2) the level of cost sharing imposed on the patient. STUDY SETTING:The 1987 National Medical Expenditure Survey, a national probability sample of the U.S. ci...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1998-12-01 00:00:00
abstract：OBJECTIVE:To compare the estimated effects of dialysis center profit status on patient survival using alternative estimation strategies with retrospective data. DATA SOURCES/STUDY SETTING:Patient and provider-level retrospective data from the United States Renal Data System (USRDS), 1996-1999. STUDY DESIGN:Observatio...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00581.x
更新日期：2006-12-01 00:00:00
abstract：OBJECTIVE:To examine how case managers in a state-funded home care program allocate home care services in response to information about a client's Medicare home health care status, with particular attention to the influence of work environment. DATA SOURCES/STUDY SETTING:Primary data collected on 355 case managers and...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.00176
更新日期：2003-10-01 00:00:00
abstract：OBJECTIVE:To examine the hospital coding response to a payment model using a case-mix measurement system based on multiple diagnoses and the resulting impact on a hospital cost model. DATA SOURCES:Financial, clinical, and supplementary data for all Ontario short stay hospitals from years 1997 to 2002. STUDY DESIGN:Di...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00270.x
更新日期：2004-08-01 00:00:00
abstract：OBJECTIVE:To illustrate how the analysis of bimodal U-shaped distributed utilization can be modeled with beta-binomial regression, which is rarely used in health services research. DATA SOURCES/STUDY SETTING:Veterans Affairs (VA) administrative data and Medicare claims in 2001-2004 for 11,123 Medicare-eligible VA prim...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12055
更新日期：2013-10-01 00:00:00
abstract：OBJECTIVE:To simplify the decision-making process, we propose and implement an approach to assess the stability of health plan performance over time when multiple indicators of performance exist. DATA SOURCE:National Committee for Quality Assurance Health Care Effectiveness Data and Information Set data for childhood ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2008.00890.x
更新日期：2008-12-01 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:We evaluate the impact of membership in a staff-model health maintenance organization (HMO) on hospital admission rates for patients presenting to an emergency department with acute chest pain. DATA SOURCES AND STUDY SETTING:Primary prospective data were gathered from all 3,006 patients presenting with a chi...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1994-04-01 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
