A New Data Resource to Examine Meals on Wheels Clients' Health Care Utilization and Costs.

Abstract:

BACKGROUND:Access to social services (eg, nutrition) can impact older adults' health care utilization and health outcomes. However, data documenting the relationship between receiving services and objective measures of health care utilization remain limited. OBJECTIVES:To link Meals on Wheels (MOW) program data to Medicare claims to enable examination of clients' health and health care utilization and to highlight the utility of this linked dataset. RESEARCH DESIGN:Using probabilistic linking techniques, we matched MOW client data to Medicare enrollment and claims data. Descriptive information is presented on clients' health and health care utilization before and after receiving services from MOW. SUBJECTS:In total, 29,501 clients were from 13 MOW programs. MEASURES:Clients' demographics, chronic conditions, and hospitalization, emergency department (ED), and nursing home (NH) utilization rates. RESULTS:We obtained a one-to-one link for 25,279 clients. Among these, 14,019 were Medicare fee-for-service (FFS) beneficiaries and met inclusion criteria for additional analyses. MOW clients had high rates of chronic conditions (eg, almost 90% of FFS clients were diagnosed with hypertension, compared with 63% of FFS beneficiaries in their communities). In the 6 months before receiving MOW services, 31.6% of clients were hospitalized, 24.9% were admitted to the ED and 13% received care in a NH. In the 6 months after receiving meals, 24.2% were hospitalized, 19.3% were admitted to the ED, and 9.5% received care in a NH. CONCLUSIONS:Linking MOW data to Medicare claims has the potential to shed additional light on the relationships among social services, health status, health care use, and benefits to clients' well-being.

journal_name

Med Care

journal_title

Medical care

authors

Shan M,Gutman R,Dosa D,Gozalo PL,Ogarek JA,Kler S,Thomas KS

doi

10.1097/MLR.0000000000000951

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

e15-e21

issue

3

eissn

0025-7079

issn

1537-1948

journal_volume

57

pub_type

杂志文章
  • A time-insensitive predictive instrument for acute hospital mortality due to congestive heart failure: development, testing, and use for comparing hospitals: a multicenter study.

    abstract::The purpose of this study was to develop a "time-insensitive" predictive instrument (TIPI) for acute hospital mortality due to congestive heart failure. In Phase 1, based on prospectively collected data on 401 congestive heart failure patients among 5,773 study patients who presented to six New England hospitals over ...

    journal_title:Medical care

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00005650-199410000-00005

    authors: Selker HP,Griffith JL,D'Agostino RB

    更新日期:1994-10-01 00:00:00

  • Can Continuity of Care Reduce Hospitalization Among Community-dwelling Older Adult Veterans Living With Dementia?

    abstract:BACKGROUND:Hospitalization is a difficult experience, especially for patients with dementia. Understanding whether better continuity of care (COC) reduces hospitalizations can indicate interventions that might help curb hospitalizations. OBJECTIVE:To estimate the causal impact of COC on hospitalizations and different ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001386

    authors: Lei L,Cai S,Conwell Y,Fortinsky RH,Intrator O

    更新日期:2020-11-01 00:00:00

  • Physician's extenders' performance in Air Force clinics.

    abstract::We evaluated the quality of care of physician's extenders (PEs: 23 physician's assistants, 7 primary care nurse practitioners) in Air Force primary medicine clinics, as part of an evaluation of PEs' assuming a considerable portion of the care, formerly provided by physicians in the military medical system. Physician's...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198109000-00007

    authors: Goldberg GA,Jolly DM,Hosek S,Chu DS

    更新日期:1981-09-01 00:00:00

  • Validly interpreting patients' reports: using bifactor and multidimensional models to determine whether surveys and scales measure one or more constructs.

    abstract:INTRODUCTION:Validly interpreting scores based on patients' reports of their experiences using scales depends on a valid scoring system. The possibility exists that, although the creators of a scale intended to create a scale measuring a single construct, the questions may seem to measure more than one construct. Howev...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e318266519e

    authors: Carle AC,Weech-Maldonado R

    更新日期:2012-09-01 00:00:00

  • Spillover effects of community uninsurance on working-age adults and seniors: an instrumental variables analysis.

    abstract:BACKGROUND:: Previous research suggests, but does not definitively establish, that a high level of uninsurance in a community may negatively affect access to and quality of health care for insured persons. OBJECTIVE:: To assess the effect of the level of uninsurance in a community on access to and satisfaction with ca...

    journal_title:Medical care

    pub_type: 杂志文章,多中心研究

    doi:10.1097/MLR.0b013e31822dc7f4

    authors: Gresenz CR,Escarce JJ

    更新日期:2011-09-01 00:00:00

  • An examination of the Resource-Based Relative Value Scale cross-specialty linkage method.

    abstract::The Resource-Based Relative Value Scale (RBRVS) was developed by surveying panels of physicians from single specialties, then merging the specialty-specific results into a common work scale. The merging process involved two steps: 1) specification of links or equivalent services across specialties: and 2) use of links...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199401000-00003

    authors: Morton SC,Kominski GF,Kahan JP

    更新日期:1994-01-01 00:00:00

  • Understanding the challenges of adjuvant treatment measurement and reporting in breast cancer: cancer treatment measuring and reporting.

    abstract:BACKGROUND:Healthcare accrediting organizations and insurers increasingly require reporting of clinical data, and cancer treatment is one area of enhanced scrutiny. OBJECTIVES:To compare rates of received versus reported adjuvant breast cancer treatments, and to assess barriers to measuring and reporting treatments to...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e3182422f7b

    authors: Bickell NA,McAlearney AS,Wellner J,Fei K,Franco R

    更新日期:2013-06-01 00:00:00

  • Changes in usual source of care and perceptions of health care access, quality, and use.

    abstract:OBJECTIVE:We sought to evaluate the extent of changes in usual source of care and associations with perceived health care access, quality, and use. RESEARCH DESIGN:We collected cross-sectional data on adults from the 1998 to 1999 Community Tracking Household Survey (n = 48,720). Linear and logistic regressions account...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-200410000-00006

    authors: Smith MA,Bartell JM

    更新日期:2004-10-01 00:00:00

  • The impact of social stressors and social networks on pediatric medical care use.

    abstract::Substantial differences in the use of pediatric medical resources reinforce the need for identifying and understanding factors that influence the use of medical services for children. This research assesses the simultaneous impact of sociodemographic characteristics, health attitudes and beliefs, psychologic distress,...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198508000-00002

    authors: Horwitz SM,Morgenstern H,Berkman LF

    更新日期:1985-08-01 00:00:00

  • Measuring the quality of care provided to community dwelling vulnerable elders dually enrolled in Medicare and Medicaid.

    abstract:CONTEXT:Small studies suggest that the quality of healthcare provided to older patients needs improvement. However, measuring the quality of care for larger groups of older adults is difficult. OBJECTIVE:To measure the quality of care in a community-dwelling vulnerable geriatric population using administrative data to...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e318127143e

    authors: Zingmond DS,Wilber KH,Maclean CH,Wenger NS

    更新日期:2007-10-01 00:00:00

  • Changes in follow-up care for Medicare surgical patients under the prospective payment system.

    abstract::In this study, changes in the number, site, and source of follow-up visits and allowed charges were examined for follow-up visits provided to Medicare surgical patients between 1984 and 1986. Among the 21 surgical procedures studied, follow-up visits decreased by 5.2%, after adjusting for case mix. Despite the physici...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199303000-00005

    authors: Kominski GF,Biddle AK

    更新日期:1993-03-01 00:00:00

  • The utility of severity of illness information in assessing the quality of hospital care. The role of the clinical trajectory.

    abstract::This research explored whether differentiating patients whose severity of illness worsened, improved, or remained the same over the hospital stay is a good screen for quality of care. The hypothesis was that substandard care is more likely to occur among patients who have worsened. Severity was measured using the Comp...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199205000-00005

    authors: Iezzoni LI,Restuccia JD,Shwartz M,Schaumburg D,Coffman GA,Kreger BE,Butterly JR,Selker HP

    更新日期:1992-05-01 00:00:00

  • Nontraditional Surrogate Decision Makers for Hospitalized Older Adults.

    abstract:BACKGROUND:Without advanced preparation of legal documents, state law determines who may serve as a surrogate decision maker for patients in hospitals. OBJECTIVES:To examine the relationship characteristics associated with traditional versus nontraditional health care surrogates who are making medical decisions for pa...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000890

    authors: Comer AR,Slaven JE,Montz A,Burke E,Inger L,Torke A

    更新日期:2018-04-01 00:00:00

  • The hospital standardized mortality ratio fallacy: a narrative review.

    abstract:BACKGROUND:Outcome measures, like hospital standardized mortality ratios (HSMRs), are increasingly used to assess quality of care. The validity of HSMRs and their accuracy to reflect quality of care is heavily contested. OBJECTIVE:We explored apparent and potential shortcomings and adverse effects of the HSMR in the a...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/MLR.0b013e31824ebd9f

    authors: van Gestel YR,Lemmens VE,Lingsma HF,de Hingh IH,Rutten HJ,Coebergh JW

    更新日期:2012-08-01 00:00:00

  • Predicting Primary Care Use Among Patients in a Large Integrated Health System: The Role of Patient Experience Measures.

    abstract:OBJECTIVE:Most Veterans Affairs (VA) Health Care System enrollees age 65+ also have the option of obtaining care through Medicare. Reliance upon VA varies widely and there is a need to optimize its prediction in an era of expanding choice for veterans to obtain care within or outside of VA. We examined whether survey-b...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001155

    authors: Wong ES,Maciejewski ML,Hebert PL,Reddy A,Liu CF

    更新日期:2019-08-01 00:00:00

  • Rates of complete colonic evaluation after incomplete colonoscopy and their associated factors: a population-based study.

    abstract:BACKGROUND:With the increasing use of colonoscopy there is growing concern about the quality of these procedures. OBJECTIVE:To evaluate the rates of complete colonic evaluation after an incomplete colonoscopy and their associated factors. METHODS:Men and women > or =50 years old living in Ontario on January 1, 1997 w...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e31817d92bc

    authors: Rizek R,Paszat LF,Stukel TA,Saskin R,Li C,Rabeneck L

    更新日期:2009-01-01 00:00:00

  • The use of physician services under a national health insurance scheme. An examination of the Canada Health Survey.

    abstract::In this paper the individual is employed as the unit of analysis to examine the extent to which the use of physician care by beneficiaries insured under the Canadian Medicare program is determined by medical needs and sociodemographic characteristics as opposed to economic considerations. The data were derived from th...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198311000-00001

    authors: Broyles RW,Manga P,Binder DA,Angus DE,Charette A

    更新日期:1983-11-01 00:00:00

  • The relationship of attitude changes to compliance with influenza immunization. A prospective study.

    abstract::In a longitudinal, prospective study of patient's decisions about influenza vaccination, the stability of attitudes about the flu and flu shots, the stability of flu shot decisions, and the relationship of attitude shifts to compliance were studied. In both 1981 and 1982 for 216 patients at high risk for complications...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198506000-00002

    authors: Buchner DM,Carter WB,Inui TS

    更新日期:1985-06-01 00:00:00

  • Healthcare disparities for American Indian veterans in the United States: a population-based study.

    abstract:OBJECTIVE:To examine healthcare coverage and access disparities for American Indian/Alaska Native (AIAN) veterans compared with non-Hispanic white veterans. METHODS:We examined national survey data for honorably discharged veterans in the United States using National Health Interview Survey (NHIS) data between 1997 an...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e3181d5f9e1

    authors: Johnson PJ,Carlson KF,Hearst MO

    更新日期:2010-06-01 00:00:00

  • Organizational Influences on Time Pressure Stressors and Potential Patient Consequences in Primary Care.

    abstract:BACKGROUND:Primary care teams face daily time pressures both during patient encounters and outside of appointments. OBJECTIVES:We theorize 2 types of time pressure, and test hypotheses about organizational determinants and patient consequences of time pressure. RESEARCH DESIGN:Cross-sectional, observational analysis ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000974

    authors: McDonald KM,Rodriguez HP,Shortell SM

    更新日期:2018-10-01 00:00:00

  • A Novel Stakeholder Engagement Approach for Patient-centered Outcomes Research.

    abstract:INTRODUCTION/OBJECTIVES:The engagement of patients and other stakeholders is a critical element in the design of patient-centered outcomes research studies. However, methodology for scalable engagement in research management particularly activities such as operationalization of principles and setting of priorities is n...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000790

    authors: Kim KK,Khodyakov D,Marie K,Taras H,Meeker D,Campos HO,Ohno-Machado L

    更新日期:2018-10-01 00:00:00

  • Lifetime patterns of payment for nursing home care.

    abstract::Although much is known about who pays the annual aggregate nursing home bill, relatively little is known about payment-source patterns of individuals during their lifetimes. In this article, lifetime payment-source patterns are analyzed for elderly nursing home users, particularly the extent to which they spend down a...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199503000-00007

    authors: Spillman BC,Kemper P

    更新日期:1995-03-01 00:00:00

  • Inter-area variations in age-adjusted health status.

    abstract::Data from the 1980 to 1981 National Health Interview Survey on morbidity, principally bed-disability days, was age standardized and indexed by region of the United States and metropolitan and nonmetropolitan residence within region. There were substantial differences in both age-specific and age-adjusted morbidity by ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198704000-00007

    authors: Blumberg MS

    更新日期:1987-04-01 00:00:00

  • Utilization of hospital resources.

    abstract::A population-based approach was used to analyze the utilization patterns of hospital care by Manitoba residents during the fiscal year 1991/1992. Patterns were analyzed for eight administrative regions, with use assigned to the patient's region of residence, regardless of the location of the hospitalization. Regional ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199512001-00008

    authors: Black CD,Roos NP,Burchill CA

    更新日期:1995-12-01 00:00:00

  • Mortality Associated With Emergency Department Boarding Exposure: Are There Differences Between Patients Admitted to ICU and Non-ICU Settings?

    abstract:BACKGROUND:Emergency Department (ED) boarding threatens patient safety. It is unclear whether boarding differentially affects patients admitted to intensive care units (ICUs) versus non-ICU settings. RESEARCH DESIGN AND SUBJECTS:We performed a 2-hospital, 18-month, cross-sectional, observational, descriptive study of ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000902

    authors: Reznek MA,Upatising B,Kennedy SJ,Durham NT,Forster RM,Michael SS

    更新日期:2018-05-01 00:00:00

  • Quality-adjusted Life Years (QALY) for 15 Chronic Conditions and Combinations of Conditions Among US Adults Aged 65 and Older.

    abstract:BACKGROUND:Although the life expectancy for the US population has increased, a high proportion of this population has lived with ≥1 chronic conditions. We have quantified the burden of disease associated with 15 chronic conditions and combinations of conditions by estimating quality-adjusted life years (QALYs) for olde...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000943

    authors: Jia H,Lubetkin EI,Barile JP,Horner-Johnson W,DeMichele K,Stark DS,Zack MM,Thompson WW

    更新日期:2018-08-01 00:00:00

  • When courts review medical appropriateness.

    abstract:OBJECTIVES:The authors examined how the courts have responded to public and private insurers' use of medical appropriateness criteria to establish coverage and payment policies. METHODS:A structured review of all federal and state court health insurance cases decided between 1960 and June 1994 that involved a dispute ...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/00005650-199808000-00016

    authors: Anderson G,Hall MA,Smith TR

    更新日期:1998-08-01 00:00:00

  • Politics and Policymaking in Medicare Part C.

    abstract:BACKGROUND:Once just a small part of the Medicare program, private managed care plans now cover over one-third of all Medicare beneficiaries and cost the Federal government ~$210 billion each year. Importantly, the evolution of Medicare managed care policy has been far from linear; for several decades there have been d...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001256

    authors: Adrion ER

    更新日期:2020-03-01 00:00:00

  • Overuse and systems of care: a systematic review.

    abstract:BACKGROUND:Current health care reform efforts are focused on reorganizing health care systems to reduce waste in the US health care system. OBJECTIVE:To compare rates of overuse in different health care systems and examine whether certain systems of care or insurers have lower rates of overuse of health care services....

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/MLR.0b013e31828dbafe

    authors: Keyhani S,Falk R,Howell EA,Bishop T,Korenstein D

    更新日期:2013-06-01 00:00:00

  • Barriers to colorectal cancer screening: a comparison of reports from primary care physicians and average-risk adults.

    abstract:BACKGROUND:Barriers to colorectal cancer (CRC) screening are not well understood. OBJECTIVES:We sought to compare barriers to CRC screening reported by primary care physicians (PCPs) and by average-risk adults, and to examine characteristics of average-risk adults who identified lack of provider recommendation as a ma...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000173599.67470.ba

    authors: Klabunde CN,Vernon SW,Nadel MR,Breen N,Seeff LC,Brown ML

    更新日期:2005-09-01 00:00:00