Influence of Peer Physicians on Intensity of End-of-Life Care for Cancer Decedents.

Abstract:

BACKGROUND:The intensity of end-of-life care varies substantially both within and between areas. Differing practice patterns of individual physicians are likely influenced by their peers. OBJECTIVE:To assess whether intensity of end-of-life care previously provided by a physician's peers influences patterns of care at the end-of-life for that physician's patients. RESEARCH DESIGN:Observational study. SUBJECTS:A total of 185,947 fee-for-service Medicare enrollees with cancer who died during 2006-2010 who were treated by 26,383 physicians. MEASURES:Spending in the last month of life, >1 emergency room visit, >1 hospitalization, intensive care unit admission in the last month of life, chemotherapy within 2 weeks of death, no/late hospice, terminal hospitalization. RESULTS:Mean (SD) spending in the last month of life was $16,237 ($17,124). For each additional $1000 of spending for a peer physician's patients in the prior year, spending for the ego physician's patients was $83 higher (P<0.001). Among physicians with peers both in and out of their practice, more of the peer effect was explained by physicians outside of the practice ($72 increase for each $1000 increase by peer physicians' patients, P<0.001) than peer physicians in the practice ($27 for each $1000 increase by within-practice peer physicians' patients, P=0.01). Results were similar across the other measures of end-of-life care intensity. CONCLUSIONS:Physician's peers exert influence on the intensity of care delivered to that physician's patients at the end-of-life. Physician education efforts led by influential providers and provider organizations may have potential to improve the delivery of high-value end-of-life care.

journal_name

Med Care

journal_title

Medical care

authors

Keating NL,O'Malley AJ,Onnela JP,Gray SW,Landon BE

doi

10.1097/MLR.0000000000001124

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

468-474

issue

6

eissn

0025-7079

issn

1537-1948

journal_volume

57

pub_type

杂志文章
  • Dental care in the People's Republic of China.

    abstract::In comparison to the living conditions that existed before 1949, the People's Republic of China (PRC) represents a remarkable story of achievement. Western knowledge about the PRC has recently increased by leaps and bounds as detente with the United States has allowed many Americans to witness the "awakening of the dr...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:

    authors: Louie R

    更新日期:1978-07-01 00:00:00

  • Antidepressant use: concordance between self-report and claims records.

    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

    authors: Kwon A,Bungay KM,Pei Y,Rogers WH,Wilson IB,Zhou Q,Adler DA

    更新日期:2003-03-01 00:00:00

  • The Effects of the Transition From Medicaid to Medicare on Health Care Use for Adults With Mental Illness.

    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

    authors: Burns ME,Huskamp HA,Smith JC,Madden JM,Soumerai SB

    更新日期:2016-09-01 00:00:00

  • Predictors of safety belt initiative by primary care physicians. A social learning theory perspective.

    abstract::Even with the passage of state safety belt laws, primary care physicians can contribute to their patients' safety by brief interventions. The present study explores the prevalence of such action with adult patients and tests the power of constructs taken from social learning theory to explain physicians' behavior. The...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198804000-00006

    authors: Mullen PD,Gottlieb NH,Biddle AK,McCuan RA,McAlister AL

    更新日期:1988-04-01 00:00:00

  • Persistent Super-Utilization of Acute Care Services Among Subgroups of Veterans Experiencing Homelessness.

    abstract:BACKGROUND:Acute health care utilization often occurs among persons experiencing homelessness. However, knowing which individuals will be persistent super-utilizers of acute care is less well understood. OBJECTIVE:The objective of the study was to identify those more likely to be persistent super-utilizers of acute ca...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000796

    authors: Szymkowiak D,Montgomery AE,Johnson EE,Manning T,O'Toole TP

    更新日期:2017-10-01 00:00:00

  • Does Offering Battlefield Acupuncture Lead to Subsequent Use of Traditional Acupuncture?

    abstract:OBJECTIVES:Veterans Health Administration encourages auricular acupuncture (Battlefield Acupuncture/BFA) as a nonpharmacologic approach to pain management. Qualitative reports highlighted a "gateway hypothesis": providing BFA can lead to additional nonpharmacologic treatments. This analysis examines subsequent use of t...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001367

    authors: Thomas ER,Zeliadt SB,Coggeshall S,Gelman H,Resnick A,Giannitrapani K,Olson J,Kligler B,Taylor SL

    更新日期:2020-09-01 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

  • Influence of knowledge and attitudes on the quality of physicians' transfusion practice.

    abstract::Studies evaluating relationships between physician background characteristics (e.g. years of practice and medical training) and quality of care have found few consistent associations. Site of practice variables have been better predictors of quality than have characteristics of individual physicians. This study explor...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199310000-00002

    authors: Salem-Schatz SR,Avorn J,Soumerai SB

    更新日期:1993-10-01 00:00:00

  • Does practice make perfect? Examining the relationship between hospital surgical volume and outcomes for hip fracture patients in Quebec.

    abstract:OBJECTIVES:Most tests of the practice-makes-perfect hypothesis have used cross-sectional data, which reveal that patients receiving surgery in high-volume hospitals tend to experience better postsurgery outcomes. This study uses longitudinal data to explicitly examine whether any given hospital's patient outcomes chang...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199806000-00012

    authors: Hamilton BH,Ho V

    更新日期:1998-06-01 00:00:00

  • Perceptions of providers and administrators in the Veterans Health Administration regarding complementary and alternative medicine.

    abstract:BACKGROUND:The integration of complementary and alternative medicine (CAM) therapies into a large organization such as the Veterans Health Administration (VHA) requires cultural change and deliberate planning to ensure feasibility and buy-in from staff and patients. At present, there is limited knowledge of VHA patient...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000225

    authors: Fletcher CE,Mitchinson AR,Trumble EL,Hinshaw DB,Dusek JA

    更新日期:2014-12-01 00:00:00

  • Physician integration strategies and hospital output. A comparison of rural and urban institutions.

    abstract::Physician integration strategies are attempts to bring physicians into hospital administration by giving them a role on the hospital board, employing them in administrative or clinical capacities, or expanding the administration issues dealt with by medical staff committees. This study used a production function model...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199007000-00005

    authors: Morrisey MA,Alexander JA,Ohsfeldt RL

    更新日期:1990-07-01 00:00:00

  • Hospital Characteristics Associated With Risk-standardized Readmission Rates.

    abstract:BACKGROUND:Safety-net and teaching hospitals are somewhat more likely to be penalized for excess readmissions, but the association of other hospital characteristics with readmission rates is uncertain and may have relevance for hospital-centered interventions. OBJECTIVE:To examine the independent association of 8 hosp...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000713

    authors: Horwitz LI,Bernheim SM,Ross JS,Herrin J,Grady JN,Krumholz HM,Drye EE,Lin Z

    更新日期:2017-05-01 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

  • Whither triazolam?

    abstract:OBJECTIVES:The authors compare the extent and nature of triazolam use before and after its deletion from a health maintenance organization's (HMO) open and advisory-type drug formulary. METHODS:Benzodiazepine dispensings of HMO members were collected for the 3 years before (1989-1991) and for the 2 years after (1992-1...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199704000-00002

    authors: Johnson RE,McFarland B,Woodson GT

    更新日期:1997-04-01 00:00:00

  • Healthcare utilization in community-acquired pneumonia episodes of care: a comparison across the continuum of managed care.

    abstract:OBJECTIVE:Compare healthcare utilization and total payments for community-acquired pneumonia (CAP) episodes-of-care among 5 health plan designs spanning the continuum of managed care. RESEARCH DESIGN:Medical and prescription claims analysis of CAP episodes among enrollees of employer-sponsored health plans. Episode ch...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e3181a8116d

    authors: Landsman PB,Smith DG,Fendrick AM

    更新日期:2009-10-01 00:00:00

  • Influencing behavior of physicians ordering laboratory tests: a literature study.

    abstract::There are various reasons why physicians order laboratory tests. Earlier studies have shown that in many cases test-ordering behavior lacks efficiency, resulting in excessive laboratory utilization. Throughout the years various attempts have been made to improve this situation. This review, based on the literature of ...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/00005650-199309000-00003

    authors: Axt-Adam P,van der Wouden JC,van der Does E

    更新日期:1993-09-01 00:00:00

  • The influence of race and ethnicity on complications and mortality after orthopedic surgery: a systematic review of the literature.

    abstract:BACKGROUND:The decision to perform orthopedic surgery requires substantial discretion and judgment. Similar conditions have been associated with health care disparities in other fields, but the extent of racial and ethnic disparities in orthopedics is unknown. OBJECTIVE:To evaluate the quality of extant orthopedic lit...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/MLR.0000000000000177

    authors: Schoenfeld AJ,Tipirneni R,Nelson JH,Carpenter JE,Iwashyna TJ

    更新日期:2014-09-01 00:00:00

  • Service use at the end-of-life in Medicare advantage versus traditional Medicare.

    abstract:BACKGROUND:Relative to traditional fee-for-service Medicare, managed care plans caring for Medicare beneficiaries may be better positioned to promote recommended services and discourage burdensome procedures with little clinical value at the end of life. OBJECTIVE:To compare end-of-life service use for enrollees in Me...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e3182a50278

    authors: Stevenson DG,Ayanian JZ,Zaslavsky AM,Newhouse JP,Landon BE

    更新日期:2013-10-01 00:00:00

  • Overall quality of life and difficulty paying for ostomy supplies in the Veterans Affairs ostomy health-related quality of life study: an exploratory analysis.

    abstract:PURPOSE:To explore whether there was a significant relationship between difficulty paying for ostomy supplies and overall quality of life among a sample of ostomates receiving care from the Veterans Health Administration (VHA). METHODS:The data were collected as part of the Veterans Affairs (VA) Ostomy Health-Related ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e318074ce9b

    authors: Coons SJ,Chongpison Y,Wendel CS,Grant M,Krouse RS

    更新日期:2007-09-01 00:00:00

  • Novel Health Information Technology to Aid Provider Recognition and Treatment of Major Depressive Disorder and Posttraumatic Stress Disorder in Primary Care.

    abstract:BACKGROUND:Millions of traumatized refugees worldwide have resettled in the United States. For one of the largest, the Cambodian community, having their mental health needs met has been a continuing challenge. A multicomponent health information technology screening tool was designed to aid provider recognition and tre...

    journal_title:Medical care

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/MLR.0000000000001036

    authors: Sorkin DH,Rizzo S,Biegler K,Sim SE,Nicholas E,Chandler M,Ngo-Metzger Q,Paigne K,Nguyen DV,Mollica R

    更新日期:2019-06-01 00:00:00

  • Will Veterans Answer Sexual Orientation and Gender Identity Questions?

    abstract:BACKGROUND:The Veterans Health Administration does not routinely collect and document sexual orientation and gender identity (SOGI) data, despite existing health disparities among sexual and gender minority Veterans. Because of the legacy of previous Department of Defense (DoD) policies that prohibited disclosure of se...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000744

    authors: Ruben MA,Blosnich JR,Dichter ME,Luscri L,Shipherd JC

    更新日期:2017-09-01 00:00:00

  • Satisfaction With Quality of Health Care Among Medicare Beneficiaries With Functional Hearing Loss.

    abstract:BACKGROUND/OBJECTIVES:Nearly 38 million Americans have hearing loss. Understanding how sensory deficits such as hearing loss, which limit communication, impact satisfaction has implications for Medicare value-based reimbursement mechanisms. The aim of this study was to characterize the association of functional hearing...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001419

    authors: Reed NS,Boss EF,Lin FR,Oh ES,Willink A

    更新日期:2021-01-01 00:00:00

  • Predictors of nursing home admission for persons with dementia.

    abstract:OBJECTIVE:The objective of this systematic review was to identify factors that consistently predict nursing home admission (NHA) in persons with dementia. METHODS:Studies published in English were retrieved by searching the MEDLINE (1966-2006), PSYCINFO (1950-2006), CINAHL (1982-2006), and Digital Dissertations (1950-...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/MLR.0b013e31818457ce

    authors: Gaugler JE,Yu F,Krichbaum K,Wyman JF

    更新日期:2009-02-01 00:00:00

  • Recurrence and care seeking after acute back pain: results of a long-term follow-up study. North Carolina Back Pain Project.

    abstract:OBJECTIVE:To explore the relationship between type of initial care as well as the likelihood of recurrence and consequent care seeking behavior. RESEARCH DESIGN:Prospective observational cohort recruited from 208 randomly selected North Carolina practices. Cohort study examined the recurrence of low back pain among pa...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199902000-00006

    authors: Carey TS,Garrett JM,Jackman A,Hadler N

    更新日期:1999-02-01 00:00:00

  • Patient adherence and medical treatment outcomes: a meta-analysis.

    abstract:BACKGROUND:Adherence is a factor in the outcome of medical treatment, but the strength and moderators of the adherence-outcome association have not been systematically assessed. OBJECTIVES:A quantitative review using meta-analysis of three decades of empirical research correlating adherence with objective measures of ...

    journal_title:Medical care

    pub_type: 杂志文章,meta分析

    doi:10.1097/00005650-200209000-00009

    authors: DiMatteo MR,Giordani PJ,Lepper HS,Croghan TW

    更新日期:2002-09-01 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

  • Inference With Difference-in-Differences With a Small Number of Groups: A Review, Simulation Study, and Empirical Application Using SHARE Data.

    abstract:BACKGROUND:Difference-in-differences (DID) estimation has become increasingly popular as an approach to evaluate the effect of a group-level policy on individual-level outcomes. Several statistical methodologies have been proposed to correct for the within-group correlation of model errors resulting from the clustering...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/MLR.0000000000000830

    authors: Rokicki S,Cohen J,Fink G,Salomon JA,Landrum MB

    更新日期:2018-01-01 00:00:00

  • Longitudinal Patterns of Spending Enhance the Ability to Predict Costly Patients: A Novel Approach to Identify Patients for Cost Containment.

    abstract:BACKGROUND:With rising health spending, predicting costs is essential to identify patients for interventions. Many of the existing approaches have moderate predictive ability, which may result, in part, from not considering potentially meaningful changes in spending over time. Group-based trajectory modeling could be u...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000623

    authors: Lauffenburger JC,Franklin JM,Krumme AA,Shrank WH,Brennan TA,Matlin OS,Spettell CM,Brill G,Choudhry NK

    更新日期:2017-01-01 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

  • Dimensions and correlates of physician work satisfaction in a midwestern city.

    abstract:OBJECTIVES:The purpose of this study was to examine the dimensions of physician work satisfaction across a variety of medical specialties and practice settings. METHODS:A modified version of the Scheckler et al survey instrument was mailed to all physicians in Marion County, Indiana. Forty-two percent (777) of the eli...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199804000-00016

    authors: Bates AS,Harris LE,Tierney WM,Wolinsky FD

    更新日期:1998-04-01 00:00:00