Abstract：
OBJECTIVE:To explore why and how health systems are engaging in care delivery redesign (CDR)-defined as the variety of tools and organizational change processes health systems use to pursue the Triple Aim. STUDY SETTING:A purposive sample of 24 health systems across 4 states as part of the Agency for Healthcare Research and Quality's Comparative Health System Performance Initiative. STUDY DESIGN:An exploratory qualitative study design to gain an "on the ground" understanding of health systems' motivations for, and approaches to, CDR, with the goals of identifying key dimensions of CDR, and gauging the depth of change that is possible based on the particular approaches to redesign care being adopted by the health systems. DATA COLLECTION:Semi-structured telephone interviews with health system executives and physician organization leaders from 24 health systems (n = 162). PRINCIPAL FINDINGS:We identify and define 13 CDR activities and find that the health systems' efforts are varied in terms of both the combination of activities they are engaging in and the depth of innovation within each activity. Health system executives who report strong internal motivation for their CDR efforts describe more confidence in their approach to CDR than those who report strong external motivation. Health system leaders face uncertainty when implementing CDR due to a limited evidence base and because of the slower than expected pace of payment change. CONCLUSIONS:The ability to validly and reliably measure CDR activities-particularly across varying organizational contexts and markets-is currently limited but is key to better understanding CDR's impact on intended outcomes, which is important for guiding both health system decision making and policy making.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Scanlon DP,Harvey JB,Wolf LJ,Vanderbrink JM,Shaw B,Shi Y,Mahmud Y,Ridgely MS,Damberg CLdoi
10.1111/1475-6773.13585subject
Has Abstractpub_date
2020-12-01 00:00:00pages
1129-1143eissn
0017-9124issn
1475-6773journal_volume
55 Suppl 3pub_type
杂志文章abstract：OBJECTIVE:To describe the key features of the first three Cash and Counseling demonstration programs and identify those which the programs have in common and those on which they differ. STUDY SETTING:Demonstration Cash and Counseling programs in Arkansas, Florida, and New Jersey. DATA SOURCES:Interviews with program ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00677.x
更新日期：2007-02-01 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：OBJECTIVE:To determine how the inclusion of post-acute evaluation and management (E&M) services as primary care affects assignment of Medicare beneficiaries to accountable care organizations (ACOs). DATA SOURCES:Medicare claims for a random 5 percent sample of 2009 Medicare beneficiaries linked to American Medical Ass...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12032
更新日期：2013-08-01 00:00:00
abstract：:This article reports an evaluation of the impact of three administrative technologies--Admission Scheduling (AS) Systems, Outpatient Surgery (OPS) Programs, and Preadmission Testing (PAT) Programs--on the number of acute care beds required by a hospital. The evaluation mechanism reported here is called the ADTECH Comp...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1985-04-01 00:00:00
abstract：OBJECTIVE:To determine whether Medicaid managed care is associated with lower hospitalization rates for ambulatory care sensitive conditions than Medicaid fee-for-service. We also explored whether there was a differential effect of Medicaid managed care by patient's race or ethnicity on the hospitalization rates for am...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2005.00340.x
更新日期：2005-02-01 00:00:00
abstract：OBJECTIVE:To develop and test predictive models of housing instability and homelessness based on responses to a brief screening instrument administered throughout the Veterans Health Administration (VHA). DATA SOURCES/STUDY SETTING:Electronic medical record data from 5.8 million Veterans who responded to the VHA's Hom...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13050
更新日期：2019-02-01 00:00:00
abstract：OBJECTIVE:To investigate whether the interaction between individual race/ethnicity and community racial/ethnic composition is associated with health-related home care use among elderly persons in the United States. DATA SOURCES:A nationally representative sample of community-dwelling elders aged 65+ from the 2000 to 2...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01135.x
更新日期：2010-10-01 00:00:00
abstract：OBJECTIVES:(1) To present the Behavioral Model for Vulnerable Populations, a major revision of a leading model of access to care that is particularly applicable to vulnerable populations; and (2) to test the model in a prospective study designed to define and determine predictors of the course of health services utiliz...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2000-02-01 00:00:00
abstract：OBJECTIVE:To compare response rate and nonresponse bias across two mixed-mode survey designs and two single-mode designs. DATA SOURCES:This experiment was embedded in a clinician survey of knowledge and attitudes regarding HPV vaccination (n = 275). STUDY DESIGN:Clinicians were randomly assigned one of two mixed-mode...
journal_title：Health services research
pub_type： 杂志文章,随机对照试验
doi：10.1111/1475-6773.12827
更新日期：2018-08-01 00:00:00
abstract：OBJECTIVE:The Standard Gamble (SG) technique is recommended for measurement of individuals' preferences under uncertainty and to express the outcome of different therapeutic choices in utility values to be used in clinical decision analysis and health program evaluation. The article alerts users of this technique to pr...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1994-06-01 00:00:00
abstract：OBJECTIVE:To produce cost estimates of proposed health insurance benefit mandates for the California legislature. DATA SOURCES:The 2001 California Health Interview Survey, 2002 Kaiser Family Foundation/Health Research and Education Trust California Employer Health Benefits Survey, Milliman Health Cost Guidelines, and ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00518.x
更新日期：2006-06-01 00:00:00
abstract：OBJECTIVE:To develop a taxonomy of governing board roles in U.S. hospitals. DATA SOURCES:2005 AHA Hospital Governance Survey, 2004 AHA Annual Survey of Hospitals, and Area Resource File. STUDY DESIGN:A governing board taxonomy was developed using cluster analysis. Results were validated and reviewed by industry exper...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2008.00835.x
更新日期：2008-08-01 00:00:00
abstract：:This article examines the effect of owning long-term care insurance policies on the amount of out-of-pocket costs incurred by the elderly during their nursing home stays, and the importance of different policy features and restrictions. Data were drawn from the 1985 National Nursing Home Survey, and from copies of lon...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1991-02-01 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 discuss and quantify the incentives that Medicare managed care plans have to avoid (through selective enrollment or disenrollment) people who are at risk for very high costs, focusing on Medicare beneficiaries in the last year of life-a group that accounts for more than one-quarter of Medicare's annual exp...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00218.x
更新日期：2004-02-01 00:00:00
abstract：:Previous research has confirmed that desirable hospital attributes as well as increased distance, or travel time, have an impact on hospital choice. These studies have become increasingly sophisticated in modeling choice. This study adds to the existing literature by estimating the effect of both hospital and individu...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1991-12-01 00:00:00
abstract：OBJECTIVE:Our research compares health care use by Medicaid beneficiaries with that of the uninsured and the privately insured to measure the program's effect on access to care. DATA SOURCES/STUDY SETTING:Data include the 1987 National Medical Expenditure Survey and the Survey of Income and Program Participation for 1...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1996-02-01 00:00:00
abstract：OBJECTIVE:To assess whether distance to services or diagnosis at a hospital-based medical center compared with a community clinic influences the receipt of psychotherapy versus pharmacotherapy for depression. DATA SOURCE:Veterans Affairs (VA) administrative data for 132,329 depressed veterans between October 2003 and ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01228.x
更新日期：2011-06-01 00:00:00
abstract：OBJECTIVE:To assess the extent and consistency of geographic differences in the use of post-acute care (PAC), and the stability of this pattern of variation. DATA SOURCES:The 5 percent Medicare data sample for 1996, 1997, and the first eight months of 1998 were used. STUDY DESIGN:Patterns of PAC use for various Diagn...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.00043
更新日期：2002-06-01 00:00:00
abstract：OBJECTIVE:To investigate new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals. DATA SOURCES:California Patient Discharge Database (PDD) and birth registry, 2008-2009, Healthcare and Cost Utilization Project's State Inpatient Database, 2008-2011, cancer registry 2000-2008, and 2010 US C...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12324
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVE:To test how Certificate of Need laws affect all-cause mortality in the United States. DATA SOURCES:The data of 1992-2011 all-cause mortality are from the Center for Disease Control's Compressed Mortality File; control variables are from the Current Population Survey, Behavioral Risk Factor Surveillance Syste...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12619
更新日期：2018-02-01 00:00:00
abstract：OBJECTIVE:To demonstrate how a researcher can investigate the appropriateness of a published comorbidity summary measure for use with a given sample. DATA SOURCE:Surveillance, Epidemiology, and End Results linked to Medicare claims data. STUDY DESIGN:We examined Kaplan-Meier estimated survival curves for four disease...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12276
更新日期：2015-08-01 00:00:00
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journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13560
更新日期：2020-09-23 00:00:00
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journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1999-04-01 00:00:00
abstract：OBJECTIVE:Examination of the extent to which federal surveys provide the data needed to estimate the coverage/cost impacts of policy alternatives to address the problem of uninsurance. DATA SOURCES/STUDY SETTING:Assessment of the major federal household surveys that regularly provide information on health insurance an...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00544.x
更新日期：2006-06-01 00:00:00
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journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：:This paper addresses two questions: (1) Does adjusting for case mix have any effect on prospective admission-based reimbursement? and (2) How does the way in which case type is defined (DRG, ICD9CM, Age, etc) affect reimbursement systems? Data from 20 Maryland hospitals provided the basis for analysis, and the results...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1983-07-01 00:00:00
abstract：OBJECTIVE:To examine the effect of the Medicare prospective payment system (PPS) for skilled nursing facilities (SNF) on the delivery of rehabilitation therapy to residents. DATA SOURCES:Resident-level data are based on the Resident Assessment Instrument Minimum Data Set for nursing facilities. All elderly residents a...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00291.x
更新日期：2004-10-01 00:00:00
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journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1987-02-01 00:00:00
abstract：OBJECTIVE:The purpose of this study is to determine whether women who have been diagnosed with HIV utilize the same volume of medical care services as men who have been diagnosed with HIV. DATA SOURCES:This study uses data from the first wave of interviews of the AIDS Cost and Service Utilization Survey (ACSUS) conduc...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1993-12-01 00:00:00
