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, but their efficiency or reasons for wide cost variation are unknown. The public health system is decentralized, with variation in organizational structure/size. We develop/compile a longitudinal dataset covering all 74 LHJs, annually from 2005 to 2012. STUDY DESIGN:We estimate a public health services/inspections cost function, where inputs are translated into outputs. We consider separate estimates of economies of scale/scope/specialization for four mandated inspection types. DATA COLLECTION/EXTRACTION METHODS:We obtain data from Connecticut Department of Public Health databases, reports, and other publicly available sources. There has been no known previous utilization of this combined dataset. PRINCIPAL FINDINGS:On average, regional districts, municipal departments, and part-time LHJs are performing fewer than the efficient number of inspections. The full-time municipal departments and regional districts are more efficient but still not at the minimum efficient scale. The regional districts' elasticities of scale are larger, implying they are more efficient than municipal health departments. CONCLUSIONS:Local health jurisdictions may enhance efficiency by increasing inspections and/or sharing some services.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Cohen JP,Checko PJdoi
10.1111/1475-6773.12740subject
Has Abstractpub_date
2017-12-01 00:00:00pages
2285-2306eissn
0017-9124issn
1475-6773journal_volume
52 Suppl 2pub_type
杂志文章abstract：OBJECTIVE:This article tests whether or not the factors that affect hospital choice differ for selected subgroups of the population. DATA SOURCES:1985 California Office of Statewide Health Planning and Development (OSHPD) discharge abstracts and hospital financial data were used. STUDY DESIGN:Models for hospital choi...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1993-06-01 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：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 county-level geographic variation in treatment admissions among opioid treatment programs (OTPs) that accept Medicaid in the continental United States. DATA SOURCES/STUDY SETTING:Data come from the 2012 National Survey of Substance Abuse Treatment Services. STUDY DESIGN/DATA COLLECTION:We used lo...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12686
更新日期：2018-02-01 00:00:00
abstract：:The concepts of class, race, and ethnicity figure prominently in health services research in Britain. Occupational class has been employed for nearly a century to investigate social inequalities in health and access to care. More recently, researchers have identified differences in health status and utilization betwee...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1995-04-01 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 examine the source of observed lower risk-adjusted mortality for blacks than whites within the Veterans Affairs (VA) system by accounting for hospital site where treated, potential under-reporting of black deaths, discretion on hospital admission, quality improvement efforts, and interactions by age group....
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00688.x
更新日期：2007-08-01 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：: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：OBJECTIVE:This study is designed to assess the cost of services provided to Medicare beneficiaries by nurse practitioners (NPs) billing under their own National Provider Identification number as compared to primary care physicians (PCMDs). DATA SOURCE:Medicare Part A (inpatient) and Part B (office visit) claims for 20...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12425
更新日期：2016-08-01 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: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: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 test the accuracy of various physicians' participation in Medicaid models. DATA SOURCES/STUDY SETTING:Primary data on 221 obstetricians and gynecologists in the Chicago area by telephone interviews over a four-month period. These data were combined with secondary data from the American Medical Association...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1997-08-01 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：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 analyze hospitalization patterns of persons with AIDS (PWAs) in a multi-state/multi-episode continuous time duration framework. DATA SOURCES:PWAs on Medicaid identified through a match between the state's AIDS Registry and Medicaid eligibility files; hospital admission and discharge dates identified throu...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1999-02-01 00:00:00
abstract：OBJECTIVE:This study investigated whether unexpected length of stay (LOS) could be used as an indicator to identify hospital patients who experienced complications or whose care exhibited low adherence to normative practices. DATA SOURCES AND STUDY SETTING:We analyzed 1,477 cases admitted for one of three medical cond...
journal_title：Health services research
pub_type： 杂志文章,评审
doi：
更新日期：1995-10-01 00:00:00
abstract：BACKGROUND:The use of Medicaid data to study cancer-related outcomes would be highly desirable. However, the accuracy of Medicaid claims data in the identification of incident cases of breast cancer is unknown. OBJECTIVES:(1) To estimate the sensitivity of Medicaid claims data for case ascertainment of breast cancer, ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.00155
更新日期：2003-06-01 00:00:00
abstract：OBJECTIVE:The Standard Gamble (SG) technique is recommended for measurement of individuals' preferences under uncertainty and to express the outcome of different therapeutic choices in utility values to be used in clinical decision analysis and health program evaluation. The article alerts users of this technique to pr...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1994-06-01 00:00:00
abstract：OBJECTIVE:To compare the performance of various risk adjustment models in behavioral health applications such as setting mental health and substance abuse (MH/SA) capitation payments or overall capitation payments for populations including MH/SA users. DATA SOURCES/STUDY DESIGN:The 1991-93 administrative data from the...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2001-08-01 00:00:00
abstract：OBJECTIVE:To identify patient characteristics and health care experiences associated with primary care linkage after alcohol or drug detoxification. DATA SOURCES/STUDY SETTING:Primary data collected over two years. Subjects were adults without primary medical care, in an urban residential detoxification program. STUD...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00246.x
更新日期：2004-06-01 00:00:00
abstract：:The concept of validity as it applies to measures of health and health status is examined in the context of a set of standard, widely accepted definitions of validity. Criterion validity is shown to be irrelevant to health status measures because of the lack of a single specific, directly observable measure of health ...
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 factors associated with guideline-concordant adjuvant therapy among breast cancer patients in a rural region of the United States and to present an advancement in quality-of-care assessment in the context of multiple treatments. DATA SOURCES:Chart abstraction on initial therapy received by 868 wom...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12269
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVE:To examine the determinants of postsurgery length of stay (LOS) and inpatient mortality in the United States (California and Massachusetts) and Canada (Manitoba and Quebec). DATA SOURCES/STUDY SETTING:Patient discharge abstracts from the Agency for Health Care Policy and Research Nationwide Inpatient Sample ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2000-03-01 00:00:00
abstract：BACKGROUND:The extent to which patient experiences with hospital care are related to other measures of hospital quality and safety is unknown. METHODS; We examined the relationship between Hospital Consumer Assessment of Healthcare Providers and Systems scores and technical measures of quality and safety using service-...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01122.x
更新日期：2010-08-01 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 examine the hospital coding response to a payment model using a case-mix measurement system based on multiple diagnoses and the resulting impact on a hospital cost model. DATA SOURCES:Financial, clinical, and supplementary data for all Ontario short stay hospitals from years 1997 to 2002. STUDY DESIGN:Di...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00270.x
更新日期：2004-08-01 00:00:00
