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 retrospective longitudinal regression analysis using hierarchical modeling of discharges clustered within hospitals. DATA COLLECTION:Detailed discharge data including costs, length of stay, and patient characteristics from the Healthcare Cost and Utilization Project State Inpatient Databases were merged with hospital survey data from the American Hospital Association. PRINCIPAL FINDINGS:Hospitals affiliated with health systems had a higher cost per discharge and better quality of care compared with independent hospitals. Centralized systems in particular had the highest cost per discharge and longest stays. Independent hospitals with managed care plans had a higher cost per discharge and better quality of care compared with other independent hospitals. CONCLUSIONS:Increasing prevalence of health systems and hospital managed care ownership may lead to higher quality but are unlikely to reduce hospital discharge costs. Encouraging participation in innovative payment and delivery reform models, such as accountable care organizations, may be more powerful options.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Henke RM,Karaca Z,Moore B,Cutler E,Liu H,Marder WD,Wong HSdoi
10.1111/1475-6773.12631subject
Has Abstractpub_date
2018-02-01 00:00:00pages
63-86issue
1eissn
0017-9124issn
1475-6773journal_volume
53pub_type
杂志文章abstract：:In the recent past, a great deal of faith has been placed in the idea that the performance of the hospital industry could be improved significantly by relying more heavily on profit incentives. This article considers the effect of profit incentives on hospital behavior and finds that the existence of profit incentives...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1985-06-01 00:00:00
abstract：OBJECTIVES:To provide updated estimates of narrow- and broad-spectrum antibiotic use among U.S. children. DATA SOURCES:Linked nationally representative data from the 2004-2010 Medical Expenditure Panel Survey Household Component and the 2000 Decennial Census. STUDY DESIGN:Relationships between individual-, family-, a...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12260
更新日期：2015-06-01 00:00:00
abstract：OBJECTIVE:To describe the development of an instrument for assessing workforce perceptions of hospital safety culture and to assess its reliability and validity. DATA SOURCES/STUDY SETTING:Primary data collected between March 2004 and May 2005. Personnel from 105 U.S. hospitals completed a 38-item paper and pencil sur...
journal_title：Health services research
pub_type： 杂志文章,随机对照试验
doi：10.1111/j.1475-6773.2007.00706.x
更新日期：2007-10-01 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：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-s...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12486
更新日期：2017-02-01 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:An ecological framework is proposed for assessing factors important to consider in allocating funds to promote sound performance of interorganizational programs. DATA SOURCE/STUDY SETTING:This framework is used to examine the first generation of Community Clinical Oncology Programs (CCOPs) funded by the Nati...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1993-04-01 00:00:00
abstract：OBJECTIVE:To evaluate episode-based payments for upper respiratory tract infections (URI) and perinatal care in Arkansas's Medicaid population. STUDY SETTING:Upper respiratory infection and perinatal episodes among Medicaid-covered individuals in Arkansas and comparison states from fiscal year (FY) 2011 to 2014. STUD...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13296
更新日期：2020-08-01 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：:A multitrait - multimethod design was employed to assess the construct validity of three commonly used methods for assessing patient compliance: physiological assessments (e.g., blood chemistries), ratings by health professionals, and patient self-reports. Subjects were patients receiving ambulatory hemodialysis treat...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1984-04-01 00:00:00
abstract：:A location model is used to determine the most efficient (i.e., least-cost) number and location of ambulance facilities in a rural area. The model incorporates response time and service time standards into the analysis and indicates the trade-off between costs and various time standards. The financial feasibility of i...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1977-10-01 00:00:00
abstract：OBJECTIVE:To assess the impact of substance abuse claims redaction on Medicare spending estimates for beneficiaries with serious mental illness. DATA SOURCES:The 2012 claims and unredacted beneficiary-level Medicare spending totals from CMS's Chronic Conditions Warehouse. STUDY DESIGN:We identified beneficiaries with...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12528
更新日期：2017-06-01 00:00:00
abstract：OBJECTIVES:To examine organizational structural attributes associated with counselor-client contact. DATA SOURCES:Data were collected in 2004 and 2005 for a federally funded project, which simultaneously examines organizational structure, functioning, and resources among outpatient substance abuse treatment programs. ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00778.x
更新日期：2008-04-01 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 estimate the total hours of paid and unpaid personal assistance of daily living provided to adults living at home in the United States using nationally representative household survey data. DATA SOURCES:The Disability Followback Survey of the National Health Interview Survey on Disability (NHIS-D) conduct...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.029
更新日期：2002-04-01 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：OBJECTIVES:Methodologically sound mixed methods research can improve our understanding of health services by providing a more comprehensive picture of health services than either method can alone. This study describes the frequency of mixed methods in published health services research and compares the presence of meth...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01344.x
更新日期：2012-04-01 00:00:00
abstract：OBJECTIVE:To provide guidance on improving the quality of case studies in health services research. DATA SOURCES:Secondary data, drawing from previous case study research. RESEARCH DESIGN:Guidance is provided to two audiences: potential case study investigators (eight items) and reviewers of case study proposals (fou...
journal_title：Health services research
pub_type： 杂志文章,评审
doi：
更新日期：1999-12-01 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 examine the effect of premiums and benefits on the health plan choices of older enrollees who choose Federal Employees Health Benefits Program (FEHBP) health plans as their primary payer. DATA SOURCES:Administrative enrollment data from the Office of Personnel Management (OPM) and plan premiums and bene...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00580.x
更新日期：2006-10-01 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：:A model is described that predicts hospital census and computes, for each day, the number of elective admissions that will maximize the census over the short run, subject to constraints on the probability of overflow. Where a computer is available the model provides detailed predictions of census in units as small as ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1977-01-01 00:00:00
abstract：:Thresholds for medical decision making are the probabilities of disease at which clinicians choose to initiate testing or therapy. A descriptive analysis of clinicians' decision making can derive their test and test-treatment thresholds and has the potential to explain variations in test utilization. A previously desc...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1986-02-01 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:The rate of coronary artery bypass surgery (CABG) has been shown to vary greatly across geographic regions. This study examined whether these rates were associated with the rate of coronary artery angioplasty (PTCA) and with other community characteristics. DATA SOURCES/STUDY SETTING:The health care financin...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1995-08-01 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：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：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 develop and test a caregiver-reported experience measure for pediatric hospital-to-home transitions. DATA SOURCES/STUDY SETTING:Primary data were collected between 07/2014 and 05/2015 from caregivers within 2-8 weeks of their child's discharge from a tertiary care children's hospital. STUDY DESIGN/DATA C...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12864
更新日期：2018-08-01 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
