Abstract:
:Two opposing theories have been suggested to describe the relationships among member dissatisfaction with a prepaid group practice (PGP), the choice to go outside for care normally covered by the plan, and disenrollment from the PGP: 1) out-of-plan use--a consequence of dissatisfaction, precedes disenrollment and 2) dissatisfaction produces two independent effects--out-of-plan use and disenrollment. Preliminary results are reported on an evaluation of these relationships based on a sample of 1823 families at the Medical Care Group of St. Louis. Dissatisfaction is found to be the most important predictor of both out-of-plan use and disenrollment. However, no direct relationship exists between the latter two variables. This result lends support for the model, which specifies that PGP members respond differently to dissatisfaction with the plan; some go outside the PGP for their care while others simply disenroll.
journal_name
Med Carejournal_title
Medical careauthors
Hennelly VD,Boxerman SBdoi
10.1097/00005650-198303000-00007subject
Has Abstractpub_date
1983-03-01 00:00:00pages
348-59issue
3eissn
0025-7079issn
1537-1948journal_volume
21pub_type
杂志文章相关文献
MEDICAL CARE文献大全abstract:BACKGROUND:Teamwork in health care settings is widely recognized as an important factor in providing high-quality patient care. However, the behaviors that comprise effective teamwork, the organizational factors that support teamwork, and the relationship between teamwork and patient outcomes remain empirical questions...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/MLR.0b013e31827feef6
更新日期:2015-04-01 00:00:00
abstract::Recent federal legislation has contained the stipulation that participating health maintenance organizations (HMOs) include a quality assurance program which stresses health outcomes. This provision was ostensibly directed at correcting alleged abuses in HMOs serving the urban poor. One version of the outcome method w...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197601000-00005
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVES:The purpose of this review is to identify and analyze published studies that have evaluated disparities for opportunistic infection (OI) prophylaxis between blacks and whites with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in the United States. METHODS:The authors conducted...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/MLR.0b013e31826c85d1
更新日期:2012-11-01 00:00:00
abstract::The Seattle Prepaid Health Care Evaluation Project is a comparative study designed to assess the care received by persons enrolled in either a large prepaid group practice (PGP) or in a prepaid, independent practice setting in which physicians are reimbursed on a fee-for-service basis (IPP). As part of the study we as...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197901000-00001
更新日期:1979-01-01 00:00:00
abstract::The effectiveness of sharing medical records in improving physician-older patient communication was evaluated in 203 ambulatory chronically ill older patients (mean age, 70.1 years) by a randomized controlled trial. Ninety-five experimental group patients received copies of their physicians' progress notes 1 week afte...
journal_title:Medical care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005650-198604000-00004
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:Research on frequent emergency department (ED) use shows that a subgroup of patients visits multiple EDs. This study characterizes these individuals. OBJECTIVE:The objective of this study was to determine how many frequent ED users seek care at multiple EDs and to identify sociodemographic, clinical, and co...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001228
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:While standard methods for conducting economic evaluations have evolved, little attention has been paid to the conduct of these studies in special populations such as children. OBJECTIVES:To build a database of pediatric economic evaluations and to examine trends in publication characteristics over a 20-yea...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.MLR.0000088451.56688.65
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Breast cancer is frequently diagnosed after an abnormal mammography result. Language barriers can complicate communication of those results. OBJECTIVES:We evaluated the association of non-English language with delay in follow-up. METHODS:Retrospective cohort study of women at 3 mammography facilities parti...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31822dcf2d
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Case-mix adjustment is widely used in health services research to ensure that groups being compared are equivalent on variables predicting outcome. There has been considerable development and testing of comorbidity indices derived from diagnostic codes recorded in administrative databases, but increasingly, ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000185749.04875.cb
更新日期:2005-12-01 00:00:00
abstract::In this study, changes in the number, site, and source of follow-up visits and allowed charges were examined for follow-up visits provided to Medicare surgical patients between 1984 and 1986. Among the 21 surgical procedures studied, follow-up visits decreased by 5.2%, after adjusting for case mix. Despite the physici...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199303000-00005
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Depression is associated with poor chronic illness outcomes, but it is unknown whether depression influences the quality of communication during the clinical encounter. We investigated whether diabetes patients with depressive symptoms, compared with those without depressive symptoms, report worse clinician-...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31816080e9
更新日期:2008-03-01 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::Data from the Cancer Control Supplement of the 1987 Health Interview Survey (NHIS), a nationally representative sample of the United States population, was used to examine rates of six screening tests for cancer. The rates of screening were compared for people who receive their usual source of medical care in an HMO o...
journal_title:Medical care
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract::Patients often receive medical care from many different providers. Consequently, the various episodes of care may not be integrated into a meaningful whole, and the quality of care may suffer. Before this possibility can be evaluated, it is necessary to develop a measure of the integrating process. The authors studied...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198405000-00004
更新日期:1984-05-01 00:00:00
abstract:BACKGROUND:Patients with chronic disease who express stronger preference for their current health might be expected to have better outcomes than patients who assign lower utility to their current health state. OBJECTIVE:We sought to examine associations between preferences for current health and outcomes in a national...
journal_title:Medical care
pub_type: 杂志文章,多中心研究
doi:10.1097/01.mlr.0000250260.28692.9b
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Increasing surgical access to previously underserved populations in the United States may require a major expansion of the use of operating rooms on weekends to take advantage of unused capacity. Although the so-called weekend effect for surgery has been described in other countries, it is unknown whether US...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000532
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Risk adjustment is useful for adjusting health care payments based on patients' health status. OBJECTIVE:This work seeks to examine how well pharmacy- and diagnosis-based risk adjusters predict child health expenditures in Medicaid populations. RESEARCH DESIGN:We used 1994-1995 Medicaid claims files for al...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000182551.87591.73
更新日期:2005-11-01 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::A prospective study was undertaken to characterize 2,000 patients attending a chiropractic teaching clinic and the effectiveness of the care they received. Fifty-two percent of the patients were between 21 and 34 years old; 41% categorized their occupation as professional and 14% as skilled blue collar; 79% presented ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198706000-00006
更新日期:1987-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Hospital-acquired catheter-associated urinary tract infection (CAUTI) is one of the first 6 conditions Medicare is targeting to reduce payment associated with hospital-acquired conditions under Congressional mandate. This study was to determine the positive predictive value (PPV) and sensitivit...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31818af83d
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:To examine longitudinal changes in Medicare-eligible veterans' reliance on the Department of Veterans Affairs (VA) healthcare system for primary and specialty care over 4 years. METHODS:We merged VA administrative and Medicare claims data to examine outpatient use during fiscal years (FY) 2001 to 2004 by 15,...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31822396c5
更新日期:2011-10-01 00:00:00
abstract:RESEARCH OBJECTIVE:Pharmacists are an expensive and limited resource in the hospital and outpatient setting. A pharmacist can spend up to 25% of their day planning. Time spent planning is time not spent delivering an intervention. A readmission risk adjustment model has potential to be used as a universal outcome-based...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001075
更新日期:2019-04-01 00:00:00
abstract::A population-based, retrospective analysis of Medicare Part A and Blue Cross hospital insurance claims data was used to determine whether hospice home care cost savings to third-party insurers are substantial and result from the substitution of less expensive home care visits for more costly hospital inpatient days. T...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198408000-00002
更新日期:1984-08-01 00:00:00
abstract::This study uses Medicare physician-claims data to examine patient and physician contributions to variations in cataract surgery rates across U.S. metropolitan areas. Utilization is modelled as having two phases: the decision to seek an ophthalmologist's care, which is made by patients, and the decision to perform surg...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199312000-00004
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:The use of league tables during the last decade has frequently been employed to assess quality in health care. However, few studies have attempted to assess quality by quantifying the variability across the organizational units or attempted to investigate whether the units are the correct context that really...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31820325c5
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:To compare mental health service utilization and its associated factors between African Americans and whites in the 1980s and 1990s. DESIGN:Household-based longitudinal study with baseline interviews in 1981 and follow-up interviews from 1993 to 1996. SETTING:The Baltimore Epidemiologic Catchment Area (ECA)...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199910000-00007
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:Decades-long efforts to require parity between behavioral and physical health insurance coverage culminated in the comprehensive federal Mental Health Parity and Addiction Equity Act. OBJECTIVES:To determine the association between federal parity and changes in mental health care utilization and spending, p...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001076
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Drug provision within the German statutory health insurance system has undergone several reforms, including the introduction of drug macrobudgets in 1993. OBJECTIVE:The objective of this study was to investigate the extent to which statutorily (SHI) and fully privately (PHI) health-insured patients were pro...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000124265.13559.02
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Numerous studies have examined the impacts of pay-for-performance programs, yet little is known about their long-term effects on health care expenses. OBJECTIVES:This study aimed to examine the long-term effects of a pay-for-performance program for diabetes care on health care utilization and expenses. MET...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31822d5d36
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Despite clinical guidelines, many patients with hypercholesterolemia do not achieve treatment goals in clinical practice. OBJECTIVES:This study examined physician attitudes and beliefs about hyperlipidemia and whether they are associated with lipid treatment decisions. METHODS:This was a cross-sectional st...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000208017.18278.1a
更新日期:2006-05-01 00:00:00