Expected source of payment and use of hospital services for coronary atherosclerosis.

Abstract:

:To study associations between payer and provision of services for patients hospitalized for coronary atherosclerosis, the authors analyzed abstracts of 24,424 discharges from California acute care hospitals during 1989. Services examined included receipt of coronary artery bypass surgery, percutaneous transluminal coronary angioplasty (PTCA), long length of stay (LOS) without revascularization, and overall LOS. Regression techniques controlled demographic factors and comorbidities. The privately insured were 96% more likely to undergo revascularization (either bypass or PTCA) than Medicaid discharges and 117% more likely than the uninsured. Odds of revascularization for Medicare and health maintenance organization discharges resembled those for the privately insured. Analyzed separately, PTCA was far more likely among the privately insured than Medicaid beneficiaries and the uninsured. In addition, the adjusted odds for PTCA were 52% greater for the privately insured than for health maintenance organization discharges. The greatest likelihood of long LOS without revascularization and the greatest overall LOS was observed for Medicaid discharges. Strong associations, consistent with financial incentives to provide care, exist between payer and provision of services. Future studies need to address whether variations in process result from differences in thresholds for procedure performance, differences in admission practices, or both.

journal_name

Med Care

journal_title

Medical care

authors

Kuykendall DH,Johnson ML,Geraci JM

doi

10.1097/00005650-199507000-00007

subject

Has Abstract

pub_date

1995-07-01 00:00:00

pages

715-28

issue

7

eissn

0025-7079

issn

1537-1948

journal_volume

33

pub_type

杂志文章
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    authors: Konrad TR,Williams ES,Linzer M,McMurray J,Pathman DE,Gerrity M,Schwartz MD,Scheckler WE,Van Kirk J,Rhodes E,Douglas J

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  • Politics and Policymaking in Medicare Part C.

    abstract:BACKGROUND:Once just a small part of the Medicare program, private managed care plans now cover over one-third of all Medicare beneficiaries and cost the Federal government ~$210 billion each year. Importantly, the evolution of Medicare managed care policy has been far from linear; for several decades there have been d...

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    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001256

    authors: Adrion ER

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  • A severity classification system for AIDS hospitalizations.

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    pub_type: 杂志文章

    doi:10.1097/00005650-198904000-00009

    authors: Turner BJ,Kelly JV,Ball JK

    更新日期:1989-04-01 00:00:00

  • Would eliminating differences in physician practice style reduce geographic variations in cataract surgery rates?

    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...

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    pub_type: 杂志文章

    doi:10.1097/00005650-199312000-00004

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  • Self-rated health assessed by web versus mail modes in a mixed mode survey: the digital divide effect and the genuine survey mode effect.

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  • Health care coverage and access to care: the status of Minnesota's veterans.

    abstract:OBJECTIVES:The primary objective of this study was to examine veterans' reliance on health care services provided by the Veterans Health Administration (VHA) within Minnesota and estimate the potential effect on uninsurance rates if all eligible veterans relied on VHA coverage. Secondary objectives were to compare vete...

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    pub_type: 杂志文章

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    更新日期:2005-08-01 00:00:00

  • Psychosocial factors affecting adherence to medical regiments in a group of hemodialysis patients.

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    journal_title:Medical care

    pub_type: 杂志文章

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  • Comparison of Nurse Staffing Measurements in Staffing-Outcomes Research.

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  • Emergence of item response modeling in instrument development and data analysis.

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    journal_title:Medical care

    pub_type: 评论,杂志文章

    doi:10.1097/00005650-200009002-00009

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  • The dynamics of health insurance among the near elderly.

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000208017.18278.1a

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  • Does practice make perfect? Part I: The relation between hospital volume and outcomes for selected diagnostic categories.

    abstract::The effect of a greater volume of patients with similar conditions being treated at a hospital on the outcomes achieved is studied using a variety of categories of patients, 15 surgical and 2 medical, and involving 550,000 patients treated in over 1,200 nonfederal United States acute care hospitals. After demonstratin...

    journal_title:Medical care

    pub_type: 杂志文章

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    更新日期:1984-02-01 00:00:00

  • Trends in mortality and medical spending in patients hospitalized for community-acquired pneumonia: 1993-2005.

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    pub_type: 杂志文章

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    journal_title:Medical care

    pub_type: 杂志文章,meta分析,评审

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    更新日期:2007-12-01 00:00:00

  • Treatment for older prostate cancer patients: disparities in a southern state.

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    journal_title:Medical care

    pub_type: 杂志文章

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    更新日期:2010-10-01 00:00:00

  • HIV testing of asymptomatic patients in U.S. hospitals.

    abstract::The human immunodeficiency virus (HIV) epidemic and the prevalence of HIV-positive persons in the population has provoked marked anxiety among hospital staffs of acquiring nosocomially transmitted HIV infections. A national telephone survey of key staff in a sample of 561 acute-care hospitals was undertaken to describ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199102000-00001

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    更新日期:1991-02-01 00:00:00

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    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 ...

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    pub_type: 杂志文章

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    更新日期:1983-09-01 00:00:00

  • Predictors of Multiple Emergency Department Utilization Among Frequent Emergency Department Users in 3 States.

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    journal_title:Medical care

    pub_type: 杂志文章

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    authors: Giannouchos TV,Washburn DJ,Kum HC,Sage WM,Ohsfeldt RL

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  • Propensity score matching to measure the effect of survey mode on reports of racial and ethnic discrimination in health care.

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    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000351

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    更新日期:2015-05-01 00:00:00

  • Healthcare task difficulty among older adults with multimorbidity.

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    journal_title:Medical care

    pub_type: 杂志文章

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  • Can administrative data be used to compare postoperative complication rates across hospitals?

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    pub_type: 杂志文章

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    更新日期:2002-10-01 00:00:00

  • Effects of Cardiovascular Health Shocks on Spouses' Work and Earnings: A National Study.

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    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001249

    authors: Jeon SH,Stepner M,Rotermann M,Fransoo R,Sanmartin C,Scales DC,Wunsch H,Iwashyna TJ,Garland A

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    pub_type: 杂志文章

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    authors: Mayer SE,Tan HJ,Peacock Hinton S,Sanoff HK,Stürmer T,Hester LL,Faurot KR,Jonsson Funk M,Lund JL

    更新日期:2019-04-01 00:00:00

  • Barriers to health care among people with disabilities who are members of underserved racial/ethnic groups: a scoping review of the literature.

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    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/MLR.0000000000000195

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    更新日期:2014-10-01 00:00:00

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    journal_title:Medical care

    pub_type: 杂志文章

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  • Quality of acute episodic care in investor-owned ambulatory health centers.

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    pub_type: 杂志文章

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    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

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    pub_type: 杂志文章

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