Abstract:
OBJECTIVES:To study the impact of eliminating cost sharing for screening mammography on mammography rates in a large Medicare Advantage (MA) health plan which in 2010 eliminated cost sharing in anticipation of the Affordable Care Act mandate. STUDY SETTING:Large MA health maintenance organization offering individual-subscriber MA insurance and employer-supplemented group MA insurance. STUDY DESIGN:We investigated the impact on breast cancer screening of a policy that eliminated a $20 copayment for screening mammography in 2010 among 53,188 women continuously enrolled from 2007 to 2012 in an individual-subscriber MA plan, compared with 42,473 women with employer-supplemented group MA insurance in the same health maintenance organization who had full screening coverage during this period. We used differences-in-differences analysis to study the impact of cost-sharing elimination on mammography rates. PRINCIPAL FINDINGS:Annual screening rates declined over time for both groups, with similar trends pre-2010 and a slower decline after 2010 among women whose copayments were eliminated. Among women aged 65-74 years in the individual-subscriber MA plan, 44.9 percent received screening in 2009 compared with 40.9 percent in 2012, while 49.5 percent of women in the employer-supplemented MA plan received screening in 2009 compared with 44.1 percent in 2012, that is, a difference-in-difference effect of 1.4 percentage points less decline in screening among women experiencing the cost-sharing elimination. Effects were concentrated among women without recent screening. There were no differences by neighborhood socioeconomic status or race/ethnicity. CONCLUSIONS:Eliminating cost sharing for screening mammography was associated with modesty lower decline in screening rates among women with previously low screening adherence.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Jena AB,Huang J,Fireman B,Fung V,Gazelle S,Landrum MB,Chernew M,Newhouse JP,Hsu Jdoi
10.1111/1475-6773.12486subject
Has Abstractpub_date
2017-02-01 00:00:00pages
191-206issue
1eissn
0017-9124issn
1475-6773journal_volume
52pub_type
杂志文章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-...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12344
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:To examine whether parental beliefs about routine checkups are associated with children's receipt of timely preventive care. DATA SOURCES:The 2001 United Way Outcomes and Community Impact Program telephone survey of San Diego County, including 918 households with children between 3 and 19 years of age, where...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00759.x
更新日期:2008-02-01 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:OBJECTIVE:To examine the predictors of unit and item nonresponse, the magnitude of nonresponse bias, and the need for nonresponse weights in the Consumer Assessment of Health Care Providers and Systems (CAHPS) Hospital Survey. METHODS:A common set of 11 administrative variables (41 degrees of freedom) was used to pred...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00476.x
更新日期:2005-12-01 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::Previous research has confirmed that desirable hospital attributes as well as increased distance, or travel time, have an impact on hospital choice. These studies have become increasingly sophisticated in modeling choice. This study adds to the existing literature by estimating the effect of both hospital and individu...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1991-12-01 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:OBJECTIVE:To examine the effect of worker heterogeneity, firm size, and establishment size on the breadth of employer health insurance offerings. DATA SOURCES:The data were drawn from the 1993 Robert Wood Johnson Foundation Employer Health Insurance Survey of 22,000 business establishments selected randomly from ten s...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2001-10-01 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: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 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 assess the value of a novel composite measure for identifying the best hospitals for major procedures. DATA SOURCE:We used national Medicare data for patients undergoing five high-risk surgical procedures between 2005 and 2008. STUDY DESIGN:For each procedure, we used empirical Bayes techniques to create...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01407.x
更新日期:2012-10-01 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 estimate county-level associations between in utero exposure to threatened evictions and preterm birth in the United States. DATA SOURCES:Complete birth records were obtained from the National Center for Health Statistics (2009-2016). Threatened evictions were measured at the county level using eviction c...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13551
更新日期:2020-10-01 00:00:00
abstract::Using existing data sources, we developed three risk-adjusted measures of hospital quality: the risk-adjusted mortality index (RAMI), the risk-adjusted readmissions index (RARI), and the risk-adjusted complication index (RACI). We describe the construction and validation of each of these indexes. After these measures ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::Using a sample of 3,000 urban hospitals, this article examines the contributions of selected hospital characteristics to variations in hospital technical efficiencies, while it accounts for multiple products and inputs, and controls for local environmental variations. Four hospital characteristics are examined: hospit...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract::The relationship between income and health is well established: the higher an individual's income, the better his or her health. However, recent research suggests that health may also be affected by the distribution of income within society. We outline the potential mechanisms underlying the so-called relative income ...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:
更新日期:1999-04-01 00:00:00
abstract::Organizations are increasingly becoming dynamic and unstable. This evolution has given rise to greater reliance on teams and increased complexity in terms of team composition, skills required, and degree of risk involved. High-reliability organizations (HROs) are those that exist in such hazardous environments where t...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00566.x
更新日期:2006-08-01 00:00:00
abstract::A decision to add a new treatment program has widespread and long-lasting implications for both the patient and the organization. Information about the interactions among the institution, the patient, and the treatment modality are seldom available. Cognitive rehabilitation is a relatively new treatment modality that ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVE:Independent freestanding emergency departments (IFEDs) have proliferated over the last decade, largely in Texas. We examined the IFED physician workforce composition and changes in emergency physician workforce supply across states and in rural Texas over the period of IFED proliferation following a 2009 legi...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13587
更新日期:2020-12-01 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: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 assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. DATA SOURCES/STUDY SETTING:Existing liter...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:10.1111/1475-6773.12420
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:To compare process of care and outcome after acute myocardial infarction, for patients with and without mental illness, cared for in the Veterans Health Administration (VA) health care system. DATA SOURCES/SETTING:Primary clinical data from 81 VA hospitals. STUDY DESIGN:This was a retrospective cohort study...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00104
更新日期:2003-02-01 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: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 estimate the effect of a nursing home's share of residents with a serious mental illness (SMI) on the quality of care. DATA SOURCES:Secondary nursing home level data over the period 2000 through 2008 obtained from the Minimum Data Set, OSCAR, and Medicare claims. STUDY DESIGN:We employ an instrumental va...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12023
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To assess the association between aggregate unemployment and hospital discharges for acute myocardial infarction (AMI) among adults and seniors, 1995-2011. DATA SOURCES/STUDY SETTING:Community hospital discharge data from states collected for the Healthcare Cost and Utilization Project (HCUP) State Inpatient...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12298
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To examine the impact of the Short Stay Transfer Policy (SSTP) on practice patterns. DATA SOURCES:This study uses data from the Centers for Medicare and Medicaid Services Medicare Provider Analysis and Review (MEDPAR) file, Home Health Standard Analytical File, 1999 Provider of Service file, and data from th...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00606.x
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVES:(1) To examine the association of socioeconomic characteristics (SES) with hospitalization by age group, and when using measures of SES at the community as opposed to the individual level. (2) Thus, to support the inference that socioeconomic factors are important in the analysis of small area utilization da...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1998-06-01 00:00:00