Abstract:
OBJECTIVE:Independent freestanding emergency departments (IFEDs) have proliferated over the last decade, largely in Texas. We examined the IFED physician workforce composition and changes in emergency physician workforce supply across states and in rural Texas over the period of IFED proliferation following a 2009 legislation allowing the licensing of these sites. DATA SOURCES:IFED websites, Texas Medical Board lookup tool, National Plan & Provider Enumeration System (NPPES), Provider Enrollment and Chain/Ownership System (PECOS), Medicare Physician Shared Patient Patterns, CareSet DocGraph Hop Teaming, Healthcare Provider Database. STUDY DESIGN:Descriptive analysis of the IFED physician workforce; quasi-experimental difference-in-difference analysis of Texas emergency physician movement into and out of the state; and difference-in-difference-in-difference analysis of the change in emergency physician supply between rural and urban areas in Texas compared with other states. DATA EXTRACTION METHODS:Using the NPIs obtained through Texas IFED websites and Texas Medical Board data, we examined NPPES/PECOS files, Medicare Physician Shared Patient Patterns, and CareSet DocGraph Hop Teaming for IFED physician practice locations from 2009 to 2017. We extracted all active emergency physicians from a Healthcare Provider Database, derived from a 5% Medicare claims (1999-2017). PRINCIPAL FINDINGS:In 2019, 545 physicians practiced in Texas IFEDs, of which 515 (94.5%) were emergency physicians. We located 533 in previous practice, of whom 522 (97.9%) previously practiced in Disproportionate Share Hospitals and 100 (18.8%) in rural areas. Following legislation to begin licensing IFEDs in 2009, there were on average 42.1 (P < .01) moving into Texas and 17.0 (P < .01) fewer moving out compared with all other states. Our results also indicated that the difference in emergency physician supply between rural and urban Texas was 1,002 (P < .01) fewer than for other states. CONCLUSIONS:New models of health care organizations such as IFEDs have workforce implications that may further exacerbate rural and underserved workforce and access challenges.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Luo Q,Chong N,Chen Cdoi
10.1111/1475-6773.13587subject
Has Abstractpub_date
2020-12-01 00:00:00pages
1013-1020issue
6eissn
0017-9124issn
1475-6773journal_volume
55pub_type
杂志文章abstract:OBJECTIVE:To compare safety climate between diverse U.S. hospitals and Veterans Health Administration (VA) hospitals, and to explore the factors influencing climate in each setting. DATA SOURCES:Primary data from surveys of hospital personnel; secondary data from the American Hospital Association's 2004 Annual Survey ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.00994.x
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of the Nursing Home Value-Based Purchasing demonstration on quality of care and Medicare spending. DATA SOURCES/STUDY SETTING:Administrative and qualitative data from Arizona, New York, and Wisconsin nursing homes over the base-year (2008-2009) and 3-year (2009-2012) demonstration peri...
journal_title:Health services research
pub_type: 杂志文章,随机对照试验
doi:10.1111/1475-6773.12538
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To examine trends in employer-sponsored health insurance coverage rates and its associated components between 2000 and 2008, to provide a baseline for later evaluations of the Affordable Care Act, and to provide information to policy makers as they design the implementation details of the law. DATA SOURCES:P...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01368.x
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:To quantify racial and socioeconomic status (SES) disparities in oral health, as measured by tooth loss, and to determine the role of dental care use and other factors in explaining disparities. DATA SOURCES/STUDY SETTING:The Florida Dental Care Study, comprising African Americans (AAs) and non-Hispanic whi...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2003.00205.x
更新日期:2003-12-01 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:OBJECTIVE:To assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. DATA SOURCES/STUDY SETTING:Existing liter...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:10.1111/1475-6773.12420
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVES:In response to rising demand and increased costs for home care services for frail elderly and disabled Medicaid clients, New York City implemented cluster care, a shared-aide model of home care. Our objective: to evaluate the effects of cluster care on home care hours and costs, client functioning, depressiv...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVE:To assess whether physicians' reported electronic health record (EHR) use provides clinical benefits and whether benefits depend on using an EHR meeting Meaningful Use criteria or length of EHR experience. DATA SOURCE:The 2011 Physician Workflow study, representative of U.S. office-based physicians. STUDY D...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12135
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To examine measures of need for health care and their relationship to utilization of health services in different racial and ethnic groups in California. DATA SOURCE:Telephone interviews obtained by random-digit dialing and conducted between April 1993 and July 1993 in California, with 7,264 adults (ages 18-...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:To develop a framework that public health practitioners could use to measure the value of public health services. DATA SOURCES:Primary data were collected from August 2006 through March 2007. We interviewed (n=46) public health practitioners in four states, leaders of national public health organizations, an...
journal_title:Health services research
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1475-6773.2009.01013.x
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:To explore state patterns in the racial life expectancy gap. DATA SOURCES:The 1997-2004 Multiple Cause of Death PUF, 2000 U.S. Census. STUDY DESIGN:We calculated life expectancy at birth for black and white men and women. DATA EXTRACTION METHODS:Data were obtained by the NCHS and U.S. Census Bureau. PRINC...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01345.x
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Many states have passed legislation mandating that health plans provide direct access to obstetricians/gynecologists (hereinafter "ob/gyns") for women, limiting the ability of plans to require referrals or otherwise restrict access. One benefit of these laws may be improved preventive screening rates, but no...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00646.x
更新日期:2007-06-01 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 financial and nonfinancial access to care and utilization of primary health care services among children of working low-income families earning below 200 percent of the federal poverty level in California, and to compare them to children in nonworking low-income families and in families earning ove...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2000-06-01 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::Increasing numbers of Americans are living with multiple chronic conditions (MCCs) and disabilities. Addressing health care needs of persons with MCCs or disabilities presents challenges on many levels. For health services researchers, priorities include (1) considering MCCs and disabilities in comparative effectivene...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2010.01145.x
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:To examine the settings of simulation evidence supporting use of nonlinear two-stage residual inclusion (2SRI) instrumental variable (IV) methods for estimating average treatment effects (ATE) using observational data and investigate potential bias of 2SRI across alternative scenarios of essential heterogenei...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12463
更新日期:2016-12-01 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:Examine the impact of the 2011 shortage of the drug cytarabine on patient receipt and timeliness of induction treatment for Acute Myeloid Leukemia (AML). STUDY DESIGN:A retrospective cohort was utilized to examine odds of receipt of inpatient induction chemotherapy and time to first dose across major (N = 10...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13028
更新日期:2018-12-01 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 demonstrate the value of shrinkage estimators when calculating a composite quality measure as the weighted average of a set of individual quality indicators. DATA SOURCES:Rates of 28 quality indicators (QIs) calculated from the minimum dataset from residents of 112 Veterans Health Administration nursing h...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01437.x
更新日期:2013-02-01 00:00:00
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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 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 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: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::This article describes a model development process that represents a useful step in classifying populations in terms of risk of institutionalization (Inst-Risk II). A four-category risk classification system--"High risk, Some risk, Low risk, and Very Low Risk"--was developed, based on combinations of measures of funct...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVE:To examine the benefits of a high-performance work environment (HPWE) for employees, patients, and hospitals. STUDY SETTING:Forty-five adult, medical-surgical units in nine hospitals in upstate New York. STUDY DESIGN:Cross-sectional study. DATA COLLECTION:Surveys were collected from 1,527 unit-based hospit...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01438.x
更新日期:2013-02-01 00:00:00
abstract:RESEARCH OBJECTIVE:To assess the impact of recent Medicare prospective payment system (PPS) changes on efficiency in skilled nursing homes. DATA SOURCE/STUDY SETTING:Medicare Cost Reports (MCR), On-line Survey Certification and Reporting System (OSCAR), Area Resource Files (ARF), a Centers for Medicare and Medicaid Se...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00798.x
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To use statistical process control charts to monitor in-hospital outcomes at the hospital level for a wide range of procedures and diagnoses. DATA SOURCES:Routine English hospital admissions data. STUDY DESIGN:Retrospective analysis using risk-adjusted log-likelihood cumulative sum (CUSUM) charts, comparing...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00742.x
更新日期:2008-02-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00282.x
更新日期:2004-08-01 00:00:00