Abstract:
OBJECTIVE:To utilize functional status (FS) outcomes to benchmark outpatient therapy clinics. DATA SOURCES:Outpatient therapy data from clinics using Focus on Therapeutic Outcomes (FOTO) assessments. STUDY DESIGN:Retrospective analysis of 538 clinics, involving 2,040 therapists and 90,392 patients admitted July 2006-June 2008. FS at discharge was modeled using hierarchical regression methods with patients nested within therapists within clinics. Separate models were estimated for all patients, for those with lumbar, and for those with shoulder impairments. All models risk-adjusted for intake FS, age, gender, onset, surgery count, functional comorbidity index, fear-avoidance level, and payer type. Inverse probability weighting adjusted for censoring. DATA COLLECTION METHODS:Functional status was captured using computer adaptive testing at intake and at discharge. PRINCIPAL FINDINGS:Clinic and therapist effects explained 11.6 percent of variation in FS. Clinics ranked in the lowest quartile had significantly different outcomes than those in the highest quartile (p < .01). Clinics ranked similarly in lumbar and shoulder impairments (correlation = 0.54), but some clinics ranked in the highest quintile for one condition and in the lowest for the other. CONCLUSIONS:Benchmarking models based on validated FS measures clearly separated high-quality from low-quality clinics, and they could be used to inform value-based-payment policies.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Gozalo PL,Resnik LJ,Silver Bdoi
10.1111/1475-6773.12344subject
Has Abstractpub_date
2016-04-01 00:00:00pages
768-89issue
2eissn
0017-9124issn
1475-6773journal_volume
51pub_type
杂志文章abstract:OBJECTIVE:Diabetes is a highly prevalent condition that results in substantial morbidity and premature mortality. We investigated how diabetes-associated mortality, disability, early retirement, and work absenteeism impacts workforce participation. DATA SOURCE:We used the Health and Retirement Study (HRS), a national ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00311.x
更新日期:2004-12-01 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: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: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 evaluate the comparative safety of laparoscopic and open colectomy across surgeons varying in experience with laparoscopy. DATA SOURCES:National Medicare data (2008-2010) for beneficiaries undergoing laparoscopic or open colectomy. STUDY DESIGN:Using instrumental variable methods to address selection bia...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12482
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:To determine whether assigning a dedicated general practitioner (GP) to a nursing home reduces hospitalizations and readmissions. DATA SOURCES/STUDY SETTING:Secondary data on hospitalizations and deaths by month for the universe of nursing home residents in Denmark from January 2011 through February 2014. S...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13112
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Patients are treated using observation services (OS) when their care needs exceed standard outpatient care (i.e., clinic or emergency department) but do not qualify for admission. Medicare and other private payers seek to limit this care setting to 48 hours. DATA SOURCE/STUDY SETTING:Healthcare Cost and Uti...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12143
更新日期:2014-06-01 00:00:00
abstract::In late 1982, as an alternative to Medicaid, Arizona implemented a prepaid, competitively bid medical care program--the Arizona Health Care Cost Containment System (AHCCCS). Before its introduction, the poor had been cared for primarily by a network of county-supported centers. Impact of the AHCCCS initiative was exam...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1985-08-01 00:00:00
abstract:OBJECTIVES:To compare the ability of two diagnosis-based risk adjustment systems and health self-report to predict short- and long-term mortality. DATA SOURCES/STUDY SETTING:Data were obtained from the Department of Veterans Affairs (VA) administrative databases. The study population was 78,164 VA beneficiaries at eig...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00622.x
更新日期:2007-04-01 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:OBJECTIVE:To investigate disparities in mental health care episodes, aligning our analyses with decisions to start or drop treatment, and choices made during treatment. STUDY DESIGN:We analyzed whites, blacks, and Latinos with probable mental illness from Panels 9-13 of the Medical Expenditure Panel Survey, assessing ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12095
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To describe the landscape of state antitrust activity and review related research and policy issues. In particular, to examine state laws that attempt to immunize mergers among healthcare providers from state and federal antitrust prosecution and consent decrees issued by state attorneys general permitting he...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:
更新日期:1998-12-01 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::Mr. Zamberlan is one of seven major executives in the Department of Veterans Affairs (VA) Veterans Health Services and Research Administration (VHS&RA), directing health care in a five-state region that includes 21 medical centers, 7 outpatient clinics, and 19 veterans outreach centers. As a medical center director in...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVES:(1) To present the Behavioral Model for Vulnerable Populations, a major revision of a leading model of access to care that is particularly applicable to vulnerable populations; and (2) to test the model in a prospective study designed to define and determine predictors of the course of health services utiliz...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVE:To examine the effect of the Medicare prospective payment system (PPS) for skilled nursing facilities (SNF) on the delivery of rehabilitation therapy to residents. DATA SOURCES:Resident-level data are based on the Resident Assessment Instrument Minimum Data Set for nursing facilities. All elderly residents a...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00291.x
更新日期:2004-10-01 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: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 determine whether Medicaid managed care is associated with lower hospitalization rates for ambulatory care sensitive conditions than Medicaid fee-for-service. We also explored whether there was a differential effect of Medicaid managed care by patient's race or ethnicity on the hospitalization rates for am...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00340.x
更新日期:2005-02-01 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:To develop novel, scalable, and valid literacy profiles for identifying limited health literacy patients by harnessing natural language processing. DATA SOURCE:With respect to the linguistic content, we analyzed 283 216 secure messages sent by 6941 diabetes patients to physicians within an integrated system'...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13560
更新日期:2020-09-23 00:00:00
abstract::The cost of capital for hospitals is a topic of continuing interest as Medicare's new capital payment policy is implemented. This study examines the determinants of tax-exempt revenue bond yields, the primary source of long-term capital for hospitals. Two important methodological issues are addressed. A probit analysi...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVE:To assess the impact of hospital affiliation, centralization, and managed care plan ownership on inpatient cost and quality. DATA SOURCES:Inpatient discharges from 3,957 community hospitals in 44 states and American Hospital Association Annual Survey data from 2010 to 2012. STUDY DESIGN:We conducted a retro...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12631
更新日期:2018-02-01 00:00:00
abstract:STUDY QUESTIONS:To determine factors that distinguish effective rural hospital consortia from ineffective ones in terms of their ability to improve members' financial performance. Two questions in particular were addressed: (1) Do large consortia have a greater collective impact on their members? (2) Does a consortium'...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:To estimate the effects of competition for both Medicare and HMO patients on the quality decisions of hospitals in Southern California. DATA SOURCE:Secondary discharge data from the Office of Statewide Health Planning and Development for the State of California for the period 1989-1993. STUDY DESIGN:Outcome...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2003.00185.x
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVES:To test whether concordance or discordance of patient participation between patients and physicians is associated with higher satisfaction, and to examine the effects of patients' and physicians' participatory styles on patients' satisfaction with their physicians. DATA:Data collected in the Texas Tech 5000...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00233.x
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:To examine facility variation in data quality of the level of pain documented in the minimum data set (MDS) as a function of level of hospice enrollment in nursing homes (NHs). DATA SOURCE:Clinical assessments on 3,469 nonhospice residents from 178 NHs were merged with On-line Survey Certification and Report...
journal_title:Health services research
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1475-6773.2005.00400.x
更新日期:2005-08-01 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::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::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