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::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::Can Medicare beneficiaries make rational and informed decisions about their coverage under the Medicare program? Recent policy developments in the Medicare program have been based on the theory of competition in medical care. One of the key assumptions of the competitive model is the free flow of adequate information,...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1988-12-01 00:00:00
abstract:OBJECTIVE:To assess the impact of Enroll America's field outreach activities on the number of individuals enrolled in Marketplace coverage during the first open enrollment period. DATA SOURCES/STUDY SETTING:Marketplace enrollment for the initial open enrollment period linked with data on Enroll America's field activit...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12630
更新日期:2018-02-01 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:BACKGROUND AND OBJECTIVES:In the last few years there has been a steady uptake of mobile phone short message service (SMS) reminders to increase medical attendance rates. We undertook a review of studies that assessed the effectiveness of SMS reminders at increasing the uptake of appointments in health care settings. ...
journal_title:Health services research
pub_type: 杂志文章,meta分析,评审
doi:10.1111/j.1475-6773.2011.01342.x
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:Substantial investment in electronic health records (EHRs) has provided an unprecedented opportunity to use clinical decision support (CDS) to increase guideline adherence. To inform efforts to maximize adoption, we characterized the adoption of an otitis media (OM) CDS system, the impact of performance feedb...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12240
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVES:To assess the relative abilities of clinical and administrative data to predict mortality and to assess hospital quality of care for CABG surgery patients. DATA SOURCES/STUDY SETTING:1991-1992 data from New York's Cardiac Surgery Reporting System (clinical data) and HCFA's MEDPAR (administrative data). STUD...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVE:To quantify the impact of multiyear utilization of preventive dental services on downstream dental care utilization and expenditures for children. DATA SOURCES/STUDY SETTING:We followed 0.93 million Medicaid-enrolled children who were 3-6 years old in 2005 from 2005 to 2011. We used Medicaid claims data of A...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12811
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To characterize the types of hospices with higher rates of patient disenrollment from the Medicare Hospice Benefit and the markets in which these hospices operate. DATA SOURCE:Secondary analyses of Surveillance, Epidemiology and End Results-Medicare data. Analyses included patients who died of cancer from 19...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.01002.x
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:To describe the key features of the first three Cash and Counseling demonstration programs and identify those which the programs have in common and those on which they differ. STUDY SETTING:Demonstration Cash and Counseling programs in Arkansas, Florida, and New Jersey. DATA SOURCES:Interviews with program ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00677.x
更新日期:2007-02-01 00:00:00
abstract::The concepts of class, race, and ethnicity figure prominently in health services research in Britain. Occupational class has been employed for nearly a century to investigate social inequalities in health and access to care. More recently, researchers have identified differences in health status and utilization betwee...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to assess nonresponse error in telephone health survey data based on an address-based sample. DATA SOURCES:Telephone and in-person interviews in Greater Boston. STUDY DESIGN/DATA COLLECTION:Interviewers attempted telephone interviews at addresses that were matched to telephon...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13110
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of health professionals' intervention on adherence to statins, the influence on total cholesterol levels, and lifestyle patterns in patients with hypercholesterolemia and analyze the differences according to the center of recruitment. STUDY SETTING:Forty-six community pharmacies and 50...
journal_title:Health services research
pub_type: 杂志文章,随机对照试验
doi:10.1111/1475-6773.13152
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVES:The Patient Activation Measure (PAM) quantifies the extent to which people are informed about and involved in their health care. Objectives were to determine the psychometric properties of PAM among multimorbid older adults and evaluate a theoretical, four-stage model of patient activation. Methods. A cross-...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2010.01210.x
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:To examine how plan premiums are associated with physician network breadth, hospital network breadth, and hospital network quality on the Affordable Care Act's Health Insurance Marketplaces in all 50 states and the DC in 2016. DATA SOURCES:Data on plan premiums and characteristics came from 2016 Robert Wood ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13447
更新日期:2020-08-13 00:00:00
abstract:OBJECTIVE:To quantify between-unit variability in mean length of stay (LoS) between intensive care units (ICUs) after adjusting for differences in case mix using a method that does not require arbitrary trimming of data. SETTING:An analysis of registry data from pediatric ICUs (PICUs) in Australia and New Zealand. ST...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01421.x
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To assess optimal activity size/mix of Connecticut local public health jurisdictions, through estimating economies of scale/scope/specialization for environmental inspections/services. DATA SOURCES/STUDY SETTING:Connecticut's 74 local health jurisdictions (LHJs) must provide environmental health services, bu...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12740
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To examine the effect of Medicaid expansions on health insurance coverage and access to care among low-income adults with behavioral health conditions. DATA SOURCES/STUDY SETTING:Nine years (2004-2012) of individual-level cross-sectional data from a restricted-access version of National Survey on Drug Use an...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12411
更新日期:2015-12-01 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 compare response rate and nonresponse bias across two mixed-mode survey designs and two single-mode designs. DATA SOURCES:This experiment was embedded in a clinician survey of knowledge and attitudes regarding HPV vaccination (n = 275). STUDY DESIGN:Clinicians were randomly assigned one of two mixed-mode...
journal_title:Health services research
pub_type: 杂志文章,随机对照试验
doi:10.1111/1475-6773.12827
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:This study examines whether parents' reports and ratings of pediatric health care vary by race/ethnicity and language in Medicaid managed care. DATA SOURCES:The data analyzed are from the National Consumer Assessment of Health Plans (CAHPS) Benchmarking Database 1.0 and consist of 9,540 children enrolled in ...
journal_title:Health services research
pub_type: 杂志文章,多中心研究
doi:
更新日期:2001-07-01 00:00:00
abstract::The axioms of utility theory are restated in terms of health outcomes, and some additional assumptions, consistent with the assumptions implicit in health status index models, are adduced to develop a consistent theory of the utility of health states. On the basis of the axioms and specific assumptions, techniques for...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVES:To examine variation in risk-adjusted reinsurance payments across Part D plans, analyze its implications for the program, and explore options to reduce reinsurance payments. DATA/STUDY DESIGN:2007-2015 Part D Plan Payment and Premium data; 2010-2013 Part D Prescription Drug Event data; and 2013 Part D Plan ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12866
更新日期:2018-12-01 00:00:00
abstract::The purpose of this study was to evaluate the applicability of a multiattribute utility model for measuring the severity of a patient's illness. A single medical problem (an analysis of the costs and benefits of different burn care systems) was used to test the model. Physicians estimated the relative importance of an...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1975-04-01 00:00:00
abstract:OBJECTIVE:To describe differences in patient experiences of hospital care by preferred language within racial/ethnic groups. DATA SOURCE:2014-2015 HCAHPS survey data. STUDY DESIGN:We compared six composite measures for seven languages (English, Spanish, Russian, Portuguese, Chinese, Vietnamese, and Other) within appl...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13105
更新日期:2019-02-01 00:00:00
abstract::This article examines forces that influence physicians to change the percentage of their admissions to a hospital (loyalty) and to cease admitting patients to a hospital altogether (exit). Because physicians are both members of a hospital and consumers of its services, their admitting patterns can be described using m...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1992-04-01 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 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::Over a two-year interval, computerized tomography (CT) scans at an urban, 400-bed Department of Veterans Affairs medical center (VAMC) were obtained in three ways. First, an in-house low-efficiency machine was used. Then, scans were done at another area hospital, in effect duplicating some aspects of regionalizing ser...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract::This article examines factors related to hospital closures, using a longitudinal sample of surviving and closed hospitals. The hospitals are drawn from three states with different regulatory programs. Size of hospital and occupancy rate are shown to be related to likelihood of closure, while ownership, length of stay,...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00