Abstract:
OBJECTIVE:The study used administrative data to identify the social determinants that have the greatest impact on Medicaid expenditures in adolescence. DATA SOURCES:Data were compiled using the Washington State Department of Social and Health Services Integrated Client Databases, which link data from state systems including Medicaid claims and social services receipt. STUDY DESIGN:Medical system and behavioral health service costs of over 180 000 Medicaid-enrolled adolescents aged 12-17 were measured using integrated administrative data from Washington State. Social determinants of health, including child maltreatment and parent risk factors, were also measured. Two-stage regression models were used to identify factors associated with increased health care utilization and costs. PRINCIPAL FINDINGS:Regression models revealed that the factors most predictive of higher health care costs were child abuse, child neglect, and instability in out-of-home placements related to foster care. Other social determinants of health, such as parent risk factors, were not associated with health care costs. Child maltreatment and placement instability impacted health care costs primarily through large increases in behavioral health utilization and costs. CONCLUSIONS:Prevention and early interventions for children and families to decrease child maltreatment and increase foster care placement stability could reduce overall health care costs.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Patton DA,Liu Q,Adelson JD,Lucenko BAdoi
10.1111/1475-6773.13052subject
Has Abstractpub_date
2019-02-01 00:00:00pages
52-63issue
1eissn
0017-9124issn
1475-6773journal_volume
54pub_type
杂志文章abstract:OBJECTIVES:To investigate whether tax-exempt hospitals' investments in community health are associated with patterns of governmental public health spending focusing specifically on the relationship between hospitals' community benefit expenditures and the spending patterns of local health departments (LHDs). STUDY DES...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12739
更新日期:2017-12-01 00:00:00
abstract::The concept of propensity to use ambulatory care is defined as the probability that a utilization occurs in a very small interval of time, given that no utilization has been observed before. With this definition of utilization, survival analysis can be used to assess the effect of a set of predictors on utilization. T...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:To determine if the availability of public ambulatory clinics affects preventable hospitalization (PH) rates of low-income and elderly populations. DATA SOURCES:PH rates were calculated using elderly and low-income discharges from 1995-97 Virginia hospital discharge data. Other data sources include the 1990 ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2001-06-01 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: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::Arthroscopic surgery of the knee has reduced in-hospital utilization of 37 percent for surgical treatment of internal derangements of the knee at The Mount Sinai Medical Center. In a study comparing arthrotomies of the knee in 1974 (N = 106) to arthroscopic surgery of the knee in 1984 (N = 221) it was found that while...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1989-12-01 00:00:00
abstract:OBJECTIVE:To investigate disparities in mental health care episodes, aligning our analyses with decisions to start or drop treatment, and choices made during treatment. STUDY DESIGN:We analyzed whites, blacks, and Latinos with probable mental illness from Panels 9-13 of the Medical Expenditure Panel Survey, assessing ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12095
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To determine whether difficulty walking and the strategies persons use to compensate for this deficit influenced downstream Medicare expenditures. DATA SOURCE:Secondary data analysis of Medicare claims data (1999-2000) for age-eligible Medicare beneficiaries (N=4,997) responding to the community portion of t...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00509.x
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To summarize the state of the art in quality improvement, review its application to care for children, and define the information that will be needed so that care for children can be further improved. PRINCIPAL FINDINGS:Health services for children exhibit numerous deficiencies in quality of care. The defici...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:
更新日期:1998-10-01 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:OBJECTIVE:Pay-for-performance (P4P) is commonly used to improve health care quality in the United States and is expected to be frequently implemented under the Affordable Care Act. However, evidence supporting its use is mixed with few large-scale, rigorous evaluations of P4P. This study tests the effect of P4P on qual...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12035
更新日期:2013-08-01 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:OBJECTIVE:To decompose the change in pediatric and adult dental care utilization over the last decade. DATA:2001 through 2010 Medical Expenditure Panel Survey. STUDY DESIGN:The Blinder-Oaxaca decomposition was used to explain the change in dental care utilization among adults and children. Changes in dental care util...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12130
更新日期:2014-04-01 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: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 investigate the role of smoking cessation in body weight. DATA SOURCES:2004-2005 and 2009-2010 Behavioral Risk Factor Surveillance Surveys (BRFSS) (N = 349,000), Centers for Disease Control and Prevention; Tax Burden on Tobacco (Orzechowski and Walker 2010). STUDY DESIGN:The Gaussian treatment effect mod...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01380.x
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:To describe differences in patient experiences of hospital care by preferred language within racial/ethnic groups. DATA SOURCE:2014-2015 HCAHPS survey data. STUDY DESIGN:We compared six composite measures for seven languages (English, Spanish, Russian, Portuguese, Chinese, Vietnamese, and Other) within appl...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13105
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To examine how case managers in a state-funded home care program allocate home care services in response to information about a client's Medicare home health care status, with particular attention to the influence of work environment. DATA SOURCES/STUDY SETTING:Primary data collected on 355 case managers and...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00176
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:To estimate the effects of competition for both Medicare and HMO patients on the quality decisions of hospitals in Southern California. DATA SOURCE:Secondary discharge data from the Office of Statewide Health Planning and Development for the State of California for the period 1989-1993. STUDY DESIGN:Outcome...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2003.00185.x
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:To determine the extent to which the elimination of behavioral health benefits for selected beneficiaries of Oregon's Medicaid program affected general medical expenditures among enrollees using outpatient mental health and substance abuse treatment services. DATA SOURCE/STUDY SETTING:Twelve months of claims...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2008.00844.x
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:To describe how the organization and dynamics of health systems changed between 1999 and 2001, in the context of expectations from the mid-1990s when managed care was in ascendance, and assess the implications for consumers and policymakers. DATA SOURCES/STUDY SETTING:Data are from the Community Tracking Stu...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00119
更新日期:2003-02-01 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:To review two indirect methods, geocoding and surname analysis, for estimating race/ethnicity as a means for health plans to assess disparities in care. STUDY DESIGN:Review of published articles and unpublished data on the use of geocoding and surname analyses. PRINCIPAL FINDINGS:Few published studies have ...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:10.1111/j.1475-6773.2006.00551.x
更新日期:2006-08-01 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:INTRODUCTION:America's community health centers (HCs) are uniquely poised to implement the patient-centered medical home (PCMH) model, as they are effective in providing comprehensive, accessible, and continuous primary care. This study aims to evaluate the relationship between PCMH recognition in HCs and clinical perf...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12523
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:To determine factors associated with ruptured appendicitis among children, using administrative databases. Insurance-related differences in the risk of ruptured appendix among adults in California have previously been described (Braveman, Schaaf, Egerter, et al. 1994). DATA SOURCES/STUDY SETTING:State of Mar...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract::The strategic behaviors of small multihospital systems have received little attention in the literature despite the fact that small systems are the predominant scale among multihospital systems. This study examines one important aspect of small-system strategic behaviors: the birth-order or evolutionary patterns of ho...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1990-06-01 00:00:00
abstract:OBJECTIVE:We evaluate the effects of the Nursing Home Quality Initiative (NHQI), which introduced quality measures to the Centers for Medicare and Medicaid Services' Nursing Home Compare website, on facility performance and consumer demand for services. DATA SOURCES:The nursing home Minimum Data Set facility reports f...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01298.x
更新日期:2011-12-01 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: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