Abstract：
OBJECTIVE:To assess the influence of relational climate on quality of diabetes care. DATA SOURCES/STUDY SETTING:The study was conducted at the Department of Veterans Affairs (VA). The VA All Employee Survey (AES) was used to measure relational climate. Patient and facility characteristics were gathered from VA administrative datasets. STUDY DESIGN:Multilevel panel data (2008-2012) with patients nested into clinics. DATA COLLECTION/EXTRACTION METHODS:Diabetic patients were identified using ICD-9 codes and assigned to the clinic with the highest frequency of primary care visits. Multiple quality indicators were used, including an all-or-none process measure capturing guideline compliance, the actual number of tests and procedures, and three intermediate continuous outcomes (cholesterol, glycated hemoglobin, and blood pressure). PRINCIPAL FINDINGS:The study sample included 327,805 patients, 212 primary care clinics, and 101 parent facilities in 2010. Across all study years, there were 1,568,180 observations. Clinics with the highest relational climate were 25 percent more likely to provide guideline-compliant care than those with the lowest relational climate (OR for a 1-unit increase: 1.02, p-value <.001). Among insulin-dependent diabetic veterans, this effect was twice as large. Contrary to that expected, relational climate did not influence intermediate outcomes. CONCLUSIONS:Relational climate is positively associated with tests and procedures provision, but not with intermediate outcomes of diabetes care.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Soley-Bori M,Benzer JK,Burgess JF Jrdoi
10.1111/1475-6773.12675subject
Has Abstractpub_date
2018-04-01 00:00:00pages
1042-1064issue
2eissn
0017-9124issn
1475-6773journal_volume
53pub_type
杂志文章abstract：OBJECTIVE:To determine if members of commercial managed care and Medicaid managed care rate the experience with their health plans differently. DATA SOURCES:Data from both commercial and Medicaid Consumer Assessment of Health Plan Surveys (CAHPS) in New York State. STUDY DESIGN:Regression models were used to determin...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.00166
更新日期：2003-08-01 00:00:00
abstract：OBJECTIVE:To assess relationships between changes in Medicare Advantage (MA) payment rates and Medicare beneficiary hospitalizations and to simulate the effects of scheduled payment cuts on ambulatory care sensitive (ACS) and elective hospitalization rates. DATA:State Inpatient Database discharge abstracts from Arizon...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01275.x
更新日期：2011-10-01 00:00:00
abstract：OBJECTIVE:To explore and understand approaches to user engagement through investigating the range of ways in which health care workers and organizations accommodated the introduction of computerized physician order entry (CPOE) and computerized decision support (CDS) for hospital prescribing. STUDY SETTING:Six hospita...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12581
更新日期：2017-10-01 00:00:00
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 differences between the general medical and mental health specialty sectors in the expenditure and treatment patterns of aged and disabled Medicare beneficiaries with a physician diagnosis of psychiatric disorder. DATA SOURCES:Based on 1991-1993 Medicare Current Beneficiary Survey data, linked to ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1999-08-01 00:00:00
abstract：OBJECTIVE:To examine the effect of rural hospital closures on the local economy. DATA SOURCES:U.S. Census Bureau, OSCAR, Medicare Cost Reports, and surveys of individuals knowledgeable about local hospital closures. STUDY DESIGN:Economic data at the county level for 1990-2000 were combined with information on hospita...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2005.00497.x
更新日期：2006-04-01 00:00:00
abstract：OBJECTIVE:To measure the association between clinician specialization in nursing home (NH) practice and outcomes of patients who received postacute care in skilled nursing facilities (SNFs). DATA SOURCES:Medicare claims and NH assessments for 2 118 941 hospital discharges to 14 526 SNFs in January 2012-October 2014 an...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13138
更新日期：2019-06-01 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：:This article describes a model development process that represents a useful step in classifying populations in terms of risk of institutionalization (Inst-Risk II). A four-category risk classification system--"High risk, Some risk, Low risk, and Very Low Risk"--was developed, based on combinations of measures of funct...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1988-10-01 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 determine whether Medicaid home care spending reduces the proportion of the disabled elderly population who do not get help with personal care. DATA SOURCES:Data on Medicaid home care spending per poor elderly person in each state is merged with data from the Medicare Current Beneficiary Survey for 1992, ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00762.x
更新日期：2008-02-01 00:00:00
abstract：OBJECTIVE:To understand patient loyalty to providers over time, informing effective population health management. STUDY SETTING:Patient care-seeking patterns over a 6-year timeframe in Minnesota, where care systems have a significant portion of their revenue generated by shared-saving contracts with public and private...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12147
更新日期：2014-06-01 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：OBJECTIVE:To examine the association between dialysis facility chain affiliation and patient mortality. STUDY SETTING:Medicare dialysis population. STUDY DESIGN:Data from the United States Renal Data System (USRDS) were used to identify 3,601 free-standing dialysis facilities and 34,914 Medicare patients' incidence t...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01219.x
更新日期：2011-06-01 00:00:00
abstract：OBJECTIVES:Eight grant teams used Agency for Healthcare Research and Quality infrastructure development research grants to enhance the clinical content of and improve race/ethnicity identifiers in statewide all-payer hospital administrative databases. PRINCIPAL FINDINGS:Grantees faced common challenges, including recr...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12330
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVE:Apply quantile regression for a high-resolution analysis of changes in wait time to treatment and assess its applicability to quality improvement data compared with least-squares regression. DATA SOURCE:Addiction treatment programs participating in the Network for the Improvement of Addiction Treatment. MET...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2012.01436.x
更新日期：2013-02-01 00:00:00
abstract：OBJECTIVE:To analyze differences in the determination of healthcare expenditures among racial/ethnic groups. DATA SOURCE:The 1987 National Medical Expenditure Survey, a nationally representative sample of the United States population. (Nomenclature reflects racial/ethnic categories as used in the Survey.) STUDY DESIG...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1998-10-01 00:00:00
abstract：OBJECTIVE:To examine the factors associated with delivery of preterm infants at neonatal intensive care unit (NICU) hospitals in Arkansas during the period 2001-2006, with a focus on the impact of a Medicaid supported intervention, Antenatal and Neonatal Guidelines, Education, and Learning System (ANGELS), that expande...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01249.x
更新日期：2011-08-01 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：OBJECTIVE:The design of health insurance, and the role out-of-pocket (OOP) payments play in it, is a key policy issue as rising health costs have encouraged greater cost-sharing measures. This paper compares the percentage of Americans spending large amounts OOP to meet their health needs with percentages in eight othe...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12444
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVE:To explore state patterns in the racial life expectancy gap. DATA SOURCES:The 1997-2004 Multiple Cause of Death PUF, 2000 U.S. Census. STUDY DESIGN:We calculated life expectancy at birth for black and white men and women. DATA EXTRACTION METHODS:Data were obtained by the NCHS and U.S. Census Bureau. PRINC...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01345.x
更新日期：2012-02-01 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:Through a review of the literature, to identify and describe (1) empirical studies of inpatient nursing care quality that evaluate links between nursing care processes and health-related patient outcomes, (2) nursing care processes for which process-outcome links have been established, and (3) important nursi...
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:We investigate the factors driving the downward trend in employer sponsored health insurance (ESI) coverage between 1999 and 2002 for low- and middle-income workers, and assess their insurance options in the absence of ESI coverage. DATA:We use the 1999 and 2002 rounds of the National Survey of America's Fam...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00590.x
更新日期：2006-12-01 00:00:00
abstract：OBJECTIVE:To investigate whether the interaction between individual race/ethnicity and community racial/ethnic composition is associated with health-related home care use among elderly persons in the United States. DATA SOURCES:A nationally representative sample of community-dwelling elders aged 65+ from the 2000 to 2...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01135.x
更新日期：2010-10-01 00:00:00
abstract：OBJECTIVE:Examination of the extent to which federal surveys provide the data needed to estimate the coverage/cost impacts of policy alternatives to address the problem of uninsurance. DATA SOURCES/STUDY SETTING:Assessment of the major federal household surveys that regularly provide information on health insurance an...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00544.x
更新日期：2006-06-01 00:00:00
abstract：:This review summarizes the capabilities and contributions of quantitative sector models for understanding trends in hospital expenses and the effects thereon of various public policies. After some brief historical notes on the use of analogous models in other policy areas, the general classes of national, partial, and...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1985-02-01 00:00:00
abstract：OBJECTIVE:To assess whether physicians' reported electronic health record (EHR) use provides clinical benefits and whether benefits depend on using an EHR meeting Meaningful Use criteria or length of EHR experience. DATA SOURCE:The 2011 Physician Workflow study, representative of U.S. office-based physicians. STUDY D...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12135
更新日期：2014-02-01 00:00:00
abstract：OBJECTIVE:To test whether nonprofit, for-profit, or government hospital ownership affects medical service provision in rural hospital markets, either directly or through the spillover effects of ownership mix. DATA SOURCES/STUDY SETTING:Data are from the American Hospital Association, U.S. Census, CMS Healthcare Cost ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01280.x
更新日期：2011-10-01 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
