Abstract:
:A common objective of health services is to provide high quality care at the least cost, yet some services achieve these objectives better than others. Moreover, there are questions about relationships between cost and quality: do higher expenditures usually result in higher quality, or, conversely, is it possible to provide higher quality of care at expenditure levels that may be lower than other institutions? This paper reports on a study of 13 acute inpatient psychiatric units in which a range of quality and direct cost outcomes was found. Some units had higher quality and lower direct costs than the others. Some had higher quality and higher direct cost, some had lower direct costs and lower quality as well, while another group had lower quality and higher direct costs. Differences in costs and quality were found to be related more to management than to patient, staff, environmental, or institutional characteristics of these units. The findings of this study suggest that proactive management that focuses on organizational outcomes, that makes consequences of operation visible, and that promotes mutual coordination will achieve higher quality and efficient performance.
journal_name
Med Carejournal_title
Medical careauthors
Schulz RI,Greenley JR,Peterson RWdoi
10.1097/00005650-198309000-00007subject
Has Abstractpub_date
1983-09-01 00:00:00pages
911-28issue
9eissn
0025-7079issn
1537-1948journal_volume
21pub_type
杂志文章相关文献
MEDICAL CARE文献大全abstract:BACKGROUND:With the increasing use of colonoscopy there is growing concern about the quality of these procedures. OBJECTIVE:To evaluate the rates of complete colonic evaluation after an incomplete colonoscopy and their associated factors. METHODS:Men and women > or =50 years old living in Ontario on January 1, 1997 w...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31817d92bc
更新日期:2009-01-01 00:00:00
abstract::While Preferred Provider Organizations (PPOs) are designed to contain the costs of health care, they may not be able to do so if sicker individuals opt not to use PPO providers. This study examined how level of mental health status and prior use of mental health services affected the decision to use or not use PPO pro...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199109000-00011
更新日期:1991-09-01 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:BACKGROUND:A requirement of the Arkansas Medicaid Section 1115 demonstration waiver was to evaluate the level of care received for Medicaid expansion eligible beneficiaries enrolled in commercial Qualified Health Plans (QHPs) in the Health Care Independence "Private Option" Program. This allowed for a direct comparison...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001248
更新日期:2020-02-01 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:BACKGROUND:The SF-12 is a multidimensional generic measure of health-related quality of life. It has become widely used in clinical trials and routine outcome assessment because of its brevity and psychometric performance, but it cannot be used in economic evaluation in its current form. OBJECTIVES:We sought to derive...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000135827.18610.0d
更新日期:2004-09-01 00:00:00
abstract::Utilization review has heretofore emphasized "length of stay" as the criterion for deciding when the patient is ready to leave the hospital. We suggest that "level of care" (the type, number, and/or intensity of a combination of physician, skilled nursing, and ancillary services) received by the patient should replace...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197506000-00004
更新日期:1975-06-01 00:00:00
abstract:BACKGROUND:Copayments (copays) for prescription drugs are a common policy among state Medicaid programs. Research exploring the effects of copays on pharmacy and health care utilization in Medicaid patients is limited, especially among patients with chronic disease. OBJECTIVES:The goal of this research was to quantify...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181734a77
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Hospital administrative health data create separate records for each hospital stay of patients. Treating a hospital transfer as a readmission could lead to biased results in health service research. METHODS:This is a cross-sectional study. We used the hospital discharge abstract database in 2013 from Albert...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000624
更新日期:2017-01-01 00:00:00
abstract::A national sample of both hospital administrators and hospital review chair-persons (the two adversarial providers in the hospital regulatory milieu) were surveyed and asked to estimate the degree and kind of unnecessary hospital utilization taking place both in the U.S. and at their own institution. Both groups indic...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198101000-00006
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Performance measurement at the provider group level is increasingly advocated, but different methods for selecting patients when calculating provider group performance have received little evaluation. OBJECTIVE:We compared 2 currently used methods according to characteristics of the patients selected and im...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31821b3604
更新日期:2011-08-01 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:OBJECTIVE:To investigate differences in self-rated health (SRH) between web and mail questionnaires in a mixed mode survey and to provide a model that explains those differences. SUBJECTS:A total of 15,200 mail respondents and 17,829 web respondents from the 2008 US National Health Survey conducted by the Gallup Panel...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31829a4f92
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVES:An important factor contributing to the steep rise in health care costs in the late 1960s was a reversal from the predominance of acute illness to that of chronic disease. Beginning with the philosophy of Illich and Levin, and the practical instruments of Fries, Sehnert, Vickery, and Ferguson, a new movement...
journal_title:Medical care
pub_type: 历史文章,杂志文章,评审
doi:10.1097/00005650-200204001-00007
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Acute health shocks can reduce the ability to work and earn among working-age survivors. The full economic impact includes labor market effects on spouses/partners, but there is a knowledge gap in this area. OBJECTIVES:The objective of this study was to assess how 3 common health shocks, acute myocardial in...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001249
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVES:To estimate cost and outcomes of the Arthritis Foundation aquatic exercise classes from the societal perspective. DESIGN:Randomized trial of 20-week aquatic classes. Cost per quality-adjusted life year (QALY) gained was estimated using trial data. Sample size was based on 80% power to reject the null hypoth...
journal_title:Medical care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005650-200105000-00002
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Econometric modeling of healthcare costs and expenditures has become an important component of decision-making across a wide array of real-world settings. OBJECTIVES:The objective of this article is to provide a brief summary of important conceptual and analytical issues involved in econometric healthcare c...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31819c9593
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:When suffering becomes unbearable for patients they might request for euthanasia. OBJECTIVE:To study which patients request for euthanasia and which requests actually resulted in euthanasia in relation with diagnosis, care setting at the end of life, and patient demographics. DESIGN:A cross-sectional study...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181dbea75
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Many health plans have outreach programs aimed at appropriately screening, evaluating, and treating women experiencing fragility fractures; however, few programs exist for men. OBJECTIVE:The objective of this study was to develop, implement, and evaluate an osteoporosis outreach program for men with a recen...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001459
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVES:The effectiveness of case-managed residential care (CMRC) in reducing substance abuse, increasing employment, decreasing homelessness, and improving health was examined. METHODS:A five-year prospective experiment included 358 homeless addicted male veterans 3, 6, and 9 months during their enrollment and at ...
journal_title:Medical care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005650-199801000-00006
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Access to social services (eg, nutrition) can impact older adults' health care utilization and health outcomes. However, data documenting the relationship between receiving services and objective measures of health care utilization remain limited. OBJECTIVES:To link Meals on Wheels (MOW) program data to Med...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000951
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Accurate estimation of medical care costs raises a host of issues, both practical and methodological. OBJECTIVES:This article reviews methods for estimating the long-term medical care costs associated with a cancer diagnosis. METHODS:The authors consider data from administrative claims databases and descri...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:
更新日期:2002-06-01 00:00:00
abstract::Between 1989 and 1992, the Agency for Health Care Policy and Research (AHCPR) awarded funding to 14 special projects known as Patient Outcomes Research Teams (PORTs). These large, complex projects form the centerpiece of the first generation of research under the Medical Treatment Effectiveness Program. In carrying ou...
journal_title:Medical care
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:There is growing attention given to the spiritual needs of dying patients and long-term care (LTC) facilities are common settings in which patients receive care as they approach death. OBJECTIVES:To describe the sources of support, the structure and processes of spiritual care in LTC, and examine the relati...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181468b5d
更新日期:2008-01-01 00:00:00
abstract::In recent years, employers, insurers, and government purchasers have paid increased attention to the measurement of patient outcomes and health status. Such interest is stimulated less by policy or quality concerns than by the need to reduce health care expenditures. Any expected benefits which might accrue from healt...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199205001-00006
更新日期:1992-05-01 00:00:00
abstract::Geriatric rehabilitation is a multidisciplinary set of evaluative, diagnostic, and therapeutic interventions whose purpose is to restore functional ability or enhance residual functional capability in elderly people with disabling impairments. The Boston Working Group on Improving Health Care Outcomes Through Geriatri...
journal_title:Medical care
pub_type:
doi:10.1097/00005650-199706001-00003
更新日期:1997-06-01 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:BACKGROUND:Without advanced preparation of legal documents, state law determines who may serve as a surrogate decision maker for patients in hospitals. OBJECTIVES:To examine the relationship characteristics associated with traditional versus nontraditional health care surrogates who are making medical decisions for pa...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000890
更新日期:2018-04-01 00:00:00
abstract::An expository account of multiple time series analysis is presented. Modeling several related time series together makes it possible to ascertain dynamic leading, lagging, and feedback relationships among the series; to produce more efficient forecasts and, in some situations; to develop control schemes. Procedures fo...
journal_title:Medical care
pub_type: 杂志文章
doi:
更新日期:1993-05-01 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