Abstract:
:Prospective payment for inpatient hospital care is based on the ideal that hospitals that produce similar outputs, as measured by the types of cases the hospital treats, should be paid similar prices. However, similar output is a multidimensional concept. Thus operationalization of this ideal will ultimately require a more complex framework for determining hospital payment rates than currently employed at either the federal or state level. This article illustrates a multidimensional approach to achieve this objective. This technique, called Grade of Membership, is used to generate a unique type of hospital group and to characterize individual hospitals in terms of their degree of similarity to these groups. In addition, a new concept of grouping is described, a variable set based on hospitals' internal cost structure is developed and used, and ordinary least squares regression is employed to compute prices for these groups. With the use of simulation analysis, these groups are compared with more conventional groups.
journal_name
Med Carejournal_title
Medical careauthors
Vertrees JC,Manton KGdoi
10.1097/00005650-198604000-00001subject
Has Abstractpub_date
1986-04-01 00:00:00pages
283-300issue
4eissn
0025-7079issn
1537-1948journal_volume
24pub_type
杂志文章相关文献
MEDICAL CARE文献大全abstract::This study was initiated to determine the extent of hospital capacity reduction in large U.S. cities. In addition, hospital bed and service additions were analyzed. Study data indicate that between 1976 and 1978 more than 5,000 beds were closed in the 36 cities surveyed. This constitutes 2.7% of total hospital beds in...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198007000-00004
更新日期:1980-07-01 00:00:00
abstract:BACKGROUND:Providing collaborative mental health treatment within primary care settings improves depression outcomes and may improve detection of mental disorders. Few studies have assessed the effect of collaborative mental health treatment programs on diagnosis of mental disorders in primary care populations. In 2008...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181e5792b
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Estimating population-level obesity rates is important for informing policy and targeting treatment. The current gold standard for obesity measurement in the United States-the National Health and Nutrition Examination Survey (NHANES)-samples <0.1% of the population and does not target state-level or health s...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000693
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Methods to select physicians most likely to benefit from educational interventions to improve the outcome of depression have not been adequately developed. OBJECTIVE:The purpose of this study was to identify a combination of primary care provider (PCP) self-report questions to improve the precision of PCP e...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-200007000-00009
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:As clinical data are increasingly collected and stored electronically, their potential use for comparative effectiveness research (CER) grows. Despite this promise, challenges face those wishing to leverage such data. In this paper we aim to enumerate some of the knowledge management and informatics issues c...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31829b1de1
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:The transition from Medicaid-only to dual Medicare/Medicaid coverage has the potential to reduce financial barriers to health care for patients with serious mental illness through increased coverage or expanded access to clinicians as their reimbursement increases. AIMS:To estimate the effect of dual covera...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000572
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:The linkage of SEER registry data with Medicare claims allows the longitudinal tracking of health care and outcomes for patients after a cancer diagnosis. One category of outcomes amenable to research using Medicare claims is complications of cancer treatments: the unintentional, adverse side effects or sequ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-200208001-00009
更新日期:2002-08-01 00:00:00
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
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVES:Adverse outcome rates are increasingly used as yardsticks for the quality of hospital care. However, the validity of many outcome studies has been undermined by the application of one outcome to all patients in large, diagnostically diverse populations, many of which lack evidence of a link between anteceden...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199708000-00003
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:Researchers need valid methods to assess whether patients are taking their antidepressant medications. Two important sources of data on drug exposure are patients' self-reports and pharmacy claims. OBJECTIVE:To compare self-report and claims data for antidepressant exposure. RESEARCH DESIGN:Cross-sectional...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.MLR.0000053019.79054.B6
更新日期:2003-03-01 00:00:00
abstract::The purpose of this article is to examine children's use of ambulatory physician services in relation to three dimensions of family life: maternal employment, single-parent versus two-parent households, and the presence of a nuclear or extended family. Data from the National Medical Care Expenditure Survey show that m...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198504000-00007
更新日期:1985-04-01 00:00:00
abstract::In 1977, the American Heart Association recommended that patients with mitral valve prolapse (MVP) and mitral insufficiency receive antibiotic prophylaxis prior to procedures that place them at risk for bacterial endocarditis. To study how clinicians conformed to this recommendation, the authors selected 126 patients ...
journal_title:Medical care
pub_type: 杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract:OBJECTIVES:To help resolve the current controversy over the validity of early readmission as an indicator of the quality of care, the authors critically reviewed the literature using meta-analysis to derive summary estimates of effect and evaluate inter-study heterogeneity. METHODS:The authors selected reports meeting...
journal_title:Medical care
pub_type: 杂志文章,meta分析
doi:10.1097/00005650-199710000-00006
更新日期:1997-10-01 00:00:00
abstract::Despite the dramatic fall in ischemic heart disease (IHD) mortality rates over the last 3 decades, it remains the number one cause of death in the United States, and one of the most frequent indications for care by the US Department of Veterans Affairs. National practice guidelines have been developed and disseminated...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:We evaluated the longitudinal course of the relationship between patient satisfaction and quality of life (QoL) in Chinese breast and nasopharyngeal cancer patients. METHODS:A sample of Chinese breast (n = 250) and nasopharyngeal (n = 242) cancer patients were assessed during their first outpatient visit (b...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181a393cf
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:To examine the effects of health plan enrollment [health maintenance organizations (HMO) or fee-for-service (FFS)], a change in Medicare reimbursement policy which allowed for annual rather than biennial mammograms, and Health Plan Employer Data Information Set (HEDIS) measures on stage at diagnosis among old...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3180616c51
更新日期:2007-08-01 00:00:00
abstract::The authors describe a new model for classifying hospitalized patients with acquired immunodeficiency syndrome (AIDS) according to their severity of illness. In the first phase of the project, a clinical model indicating the relative severity of AIDS complications was formulated, based on the clinical literature and e...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198904000-00009
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:Services targeting social determinants of health-such as income support, housing, and nutrition-have been shown to improve health outcomes and reduce health care costs for older adults. Nevertheless, evidence on the properties of effective collaborative networks across health care and social services sectors...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001097
更新日期:2019-05-01 00:00:00
abstract::This study uses a new database containing clinical risk factors for cardiac surgery to investigate the relationship between surgical volume (hospital and surgeon) and inhospital mortality rate for all patients receiving coronary artery bypass surgery in New York State in 1989. Also, hospitals with significantly higher...
journal_title:Medical care
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract::Research indicates that approximately one in five hospital admissions is unnecessary or inappropriate, based on accepted clinical criteria. Various cost-containment approaches have been initiated to reduce unnecessary hospital care. Among these approaches, hospital utilization review (UR) has shown promise as a cost-c...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198906000-00006
更新日期:1989-06-01 00:00:00
abstract::A randomized clinical trial was performed to assess whether the results of a depression screening instrument, when provided to physicians, could influence their recognition and treatment of depression in a primary care setting. The intervention consisted of randomly informing or not informing physicians of the depress...
journal_title:Medical care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005650-199003000-00004
更新日期:1990-03-01 00:00:00
abstract::The cost of obstetric care delivered in a cooperative care unit was compared with the cost for similar patients treated in a traditional inpatient maternity unit. The study sample contained 1,683 consecutive patients representing 23 diagnosis categories. The analysis indicates that cooperative care patients had signif...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198806000-00008
更新日期:1988-06-01 00:00:00
abstract::Satisfaction with health services is an aspect of quality of care that is of special importance for captive clients like low-income clinic users. Several methodologies have been reported, but validation has been difficult. This study compares two older scaling techniques with a new, nonmetric method to detect underlyi...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197803000-00003
更新日期:1978-03-01 00:00:00
abstract::Foreign-born physicians graduated from foreign medical schools who were unlicensed in California are described by nationality, age, sex, location, visa status, employment, English fluency, and specialty. Over 1,210 unlicensed foreign medical graduates (FMGs) were located in California and 736 were interviewed, approxi...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198312000-00004
更新日期:1983-12-01 00:00:00
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
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Patient-centered communication (PCC) is associated with more appropriate treatment of depression in primary care. Aside from patient presentation, little is known about other influences on PCC. We investigated whether PCC is influenced by personality dispositions of primary care providers, independent of pat...
journal_title:Medical care
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/MLR.0b013e31817924e4
更新日期:2008-08-01 00:00:00
abstract::A valid and reliable vignette-based measure of DSM-III psychiatric diagnostic knowledge was administered to practicing primary care physicians (PCPs; generally, internal and family practice medicine) and mental health professionals (MHPs, in psychiatry and psychology). Recognition, diagnosis, and treatment recommendat...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198909000-00003
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:Rural health care workforce forecasting has not included adjustments for predictable changes in practice patterns, such as the introduction of practice guidelines. PURPOSE:To estimate the impact of a practice guideline for a single health condition on the needs of a rural health professional workforce. MET...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199903000-00006
更新日期:1999-03-01 00:00:00
abstract::Nurse anesthetists (CRNAs) are a lower cost substitute for anesthesiologists in the delivery of anesthesia services. This article addresses the question of when anesthesiologists delegate in a team approach as opposed to using a solo arrangement. Logistic regression analysis was done using data from the 1986 Anesthesi...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198905000-00002
更新日期:1989-05-01 00:00:00
abstract:BACKGROUND:Previous studies of nonresponders have not assessed the effects of nonresponse on the accuracy of clinician behavior measurements. Knowledge of these effects is critical to both research and quality improvement. OBJECTIVE:To evaluate the hypothesis that nonresponders to a survey would not adversely affect t...
journal_title:Medical care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005650-200204000-00010
更新日期:2002-04-01 00:00:00