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 studies, which focus on rural HMOs, are qualitative in nature and generally are directed at identifying factors that facilitate or retard HMO development. Despite their limitations, the studies do raise a variety of issues deserving of quantitative analysis. Research is now needed that (1) investigates the effect of rural alternative delivery systems on the cost and quality of care received by rural residents, (2) assesses the effectiveness of different mechanisms used by these systems to contain costs, (3) estimates the effect of alternative delivery systems on rural providers, (4) determines the extent to which the presence or absence of alternative delivery systems influences physician decisions to locate in rural areas, (5) identifies factors that are important in consumer decisions to enroll or not enroll in a rural alternative delivery system, and (6) analyzes the diffusion patterns of these systems in rural areas.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Christianson JBsubject
Has Abstractpub_date
1989-02-01 00:00:00pages
849-89issue
6eissn
0017-9124issn
1475-6773journal_volume
23pub_type
历史文章,杂志文章,评审abstract::We examined the expansion of Veterans Administration (now Department of Veterans Affairs--VA) inpatient psychiatric services from 1963 to 1984. Aggregate national trends in VA inpatient episodes between 1963 and 1984 document not only increased use of inpatient services but also "decentralization," or a shift to provi...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVE:To examine factors associated with Medicaid acceptance for substance abuse (SA) services by outpatient SA treatment programs. DATA SOURCES:Secondary analysis of 2003-2006 National Survey of Substance Abuse Treatment Services data combined with state Medicaid policy and usage measures and other publicly avail...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2010.01206.x
更新日期:2011-04-01 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:OBJECTIVE:To examine the settings of simulation evidence supporting use of nonlinear two-stage residual inclusion (2SRI) instrumental variable (IV) methods for estimating average treatment effects (ATE) using observational data and investigate potential bias of 2SRI across alternative scenarios of essential heterogenei...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12463
更新日期:2016-12-01 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 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::All admissions to a 1,100-bed Department of Veterans Affairs (VA) hospital were screened to identify 171 terminally ill patients with informal caregivers who were then randomly assigned to VA hospital-based team home care (HBHC, N = 85) or customary care (N = 86). Patient functioning, and patient and caregiver morale ...
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:1992-02-01 00:00:00
abstract::This article analyzes three methods used to forecast the transition of long-term care clients through a variety of possible home and facility placements and levels of care. The test population (N = 1,653) is derived from the larger population of clients admitted in 1978 to British Columbia's newly established Long-Ter...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract:BACKGROUND:In 2004, the State of Wisconsin introduced a change to their Medicaid Policy allowing medical care providers to be reimbursed for fluoride varnish treatment provided to Medicaid enrolled children. OBJECTIVE:To determine the extent by which a state-level policy change impacted access to fluoride varnish trea...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.00975.x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:We estimate long-term health care costs of former smokers compared with continuing and never smokers using a retrospective cohort study of HMO enrollees. Previous research on health care costs associated with former smokers has suggested that quitters may incur greater health care costs than continuing smoker...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00142
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:To develop and test predictive models of housing instability and homelessness based on responses to a brief screening instrument administered throughout the Veterans Health Administration (VHA). DATA SOURCES/STUDY SETTING:Electronic medical record data from 5.8 million Veterans who responded to the VHA's Hom...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13050
更新日期:2019-02-01 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::Based on organization theory and the work of Roemer and Friedman, seven dimensions of hospital medical staff organization structure are proposed and examined. The data are based on a 1973 nationwide survey of hospital medical staffs conducted by the American Hospital Association. Factor analysis yielded six relatively...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract:OBJECTIVE:To assess the effect of dissemination and implementation of an intervention consisting of practice facilitation and a risk-stratified, population management dashboard on cardiovascular risk reduction for patients at high risk in small, primary care practices. STUDY SETTING:A total of 219 small primary care p...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13571
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:We study the association between the timing of the Great Recession (GR) and health spending among uninsured adults distinguishing by citizenship/nativity status and time of U.S. residence. DATA SOURCE:Uninsured U.S. citizens and noncitizens from the 2005-2006 and 2008-2009 Medical Expenditure Panel Survey. ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12193
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:To construct a data tool, the Residential History File (RHF), that summarizes information from Medicare claims and nursing home (NH) Minimum Data Set (MDS) assessments to track people through health care locations, including non-Medicare-paid NH stays. DATA SOURCES:Online Survey of Certification and Reportin...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2010.01194.x
更新日期:2011-02-01 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:OBJECTIVES:To assess the ability of an Adjusted Clinical Group (ACG)-based morbidity measure to assess the overall health service needs of populations. Data Sources/Study Setting. Three population-based secondary data sources: registration and health service utilization data from fiscal year 1995-1996; mortality data f...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.01029
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the role of health plan benefit design and price on consumers' decisions to purchase health insurance in the nongroup market and their choice of plan. DATA SOURCES AND STUDY SETTING:Administrative data from the three largest nongroup insurers in California and survey data about those insured in t...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00726.x
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:To examine the relationship between features of managed care organizations (MCOs) and health care use patterns by children. DATA SOURCES:Telephone survey data from 2,223 parents of children with special health care needs, MCO-administrator interview data, and health care claims data. STUDY DESIGN:Cross-sect...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2003.00195.x
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:To efficiently estimate race/ethnicity using administrative records to facilitate health care organizations' efforts to address disparities when self-reported race/ethnicity data are unavailable. DATA SOURCE:Surname, geocoded residential address, and self-reported race/ethnicity from 1,973,362 enrollees of a...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2008.00854.x
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To test the effects of state prescription contraception insurance mandates on unintended, mistimed, and unwanted births in a sample of privately insured recent mothers. DATA:We pooled Pregnancy Risk Assessment Monitoring System (PRAMS) data from 1997 to 2012 to study 209,964 privately insured recent mothers ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12792
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To understand reasons why California has lower Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores than the rest of the country, including differing patterns of CAHPS scores between Medicare Advantage (MA) and fee-for-service, effects of additional demographic characteristics of beneficiari...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01279.x
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To determine if the incidence of psychiatric emergencies involving drugs or alcohol supports the argument that mentally ill persons contribute to elevated mortality during the days following disbursement of private earnings and public income transfers. STUDY DESIGN:Interrupted time-series using Box-Jenkins m...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2000-10-01 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:OBJECTIVE:To examine the influence of dimensions of service quality on patient experience of primary care. DATA SOURCES/STUDY SETTING:Data from the national GP Patient Survey in England 2014/15, with responses from 858,351 patients registered at 7,918 practices. STUDY DESIGN:Expert panel and principal component analy...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12985
更新日期:2018-12-01 00:00:00
abstract:STUDY QUESTION:Continuous quality improvement (CQI) has been implemented at least to some degree in many health care settings, yet randomized controlled trials (RCTs) of CQI are rare. We ask whether, when, and how RCTs of CQI might be designed. STUDY DESIGN:We consider two applications of CQI: as a general philosophy ...
journal_title:Health services research
pub_type: 评论,杂志文章
doi:
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:To investigate the role of smoking cessation in body weight. DATA SOURCES:2004-2005 and 2009-2010 Behavioral Risk Factor Surveillance Surveys (BRFSS) (N = 349,000), Centers for Disease Control and Prevention; Tax Burden on Tobacco (Orzechowski and Walker 2010). STUDY DESIGN:The Gaussian treatment effect mod...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01380.x
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:Patients discharged from a self-managed nursing unit are compared with patients from traditionally managed units on postdischarge outcomes. DATA SOURCES AND STUDY SETTING:Primary data were collected on patients discharged from eight nursing units in three clinical areas in one hospital from August through No...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1994-10-01 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