Abstract：
OBJECTIVE:As part of a project to estimate physician requirements for the Department of Veterans Affairs, the Institute of Medicine (IOM) developed and tested empirically based models of physician staffing, by specialty, that could be applied to each VA facility. DATA SOURCE/STUDY SETTING:These analyses used selected data on all patient encounters and all facilities in VA's management information systems for FY 1989. STUDY DESIGN:Production functions (PFs), with patient workload dependent on physicians, other providers, and nonpersonnel factors, were estimated for each of 14 patient care areas in a VA medical center. Inverse production functions (IPFs), with physician staffing levels dependent on workload and other factors, were estimated for each of 11 specialty groupings. These models provide complementary approaches to deriving VA physician requirements for patient care and medical education. DATA COLLECTION/EXTRACTION METHODS:All data were assembled by VA and put in analyzable SAS data sets containing FY 1989 workload and staffing variables used in the PFs and IPFs. All statistical analyses reported here were conducted by the IOM. PRINCIPAL FINDINGS:Existing VA data can be used to develop statistically strong, clinically plausible, empirically based models for calculating physician requirements, by specialty. These models can (1) compare current physician staffing in a given setting with systemwide norms and (2) yield estimates of future staffing requirements conditional on future workload. CONCLUSIONS:Empirically based models can play an important role in determining VA physician staffing requirements. VA should test, evaluate, and revise these models on an ongoing basis.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Lipscomb J,Kilpatrick KE,Lee KL,Pieper KSsubject
Has Abstractpub_date
1995-02-01 00:00:00pages
697-717issue
6eissn
0017-9124issn
1475-6773journal_volume
29pub_type
杂志文章abstract：OBJECTIVE:To examine whether parental beliefs about routine checkups are associated with children's receipt of timely preventive care. DATA SOURCES:The 2001 United Way Outcomes and Community Impact Program telephone survey of San Diego County, including 918 households with children between 3 and 19 years of age, where...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00759.x
更新日期：2008-02-01 00:00:00
abstract：OBJECTIVE:Patients discharged from a self-managed nursing unit are compared with patients from traditionally managed units on postdischarge outcomes. DATA SOURCES AND STUDY SETTING:Primary data were collected on patients discharged from eight nursing units in three clinical areas in one hospital from August through No...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1994-10-01 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：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 examine differences between the general medical and mental health specialty sectors in the expenditure and treatment patterns of aged and disabled Medicare beneficiaries with a physician diagnosis of psychiatric disorder. DATA SOURCES:Based on 1991-1993 Medicare Current Beneficiary Survey data, linked to ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1999-08-01 00:00:00
abstract：OBJECTIVE:To test the hypothesis that a greater commitment to strategic adaptation, as exhibited by more extensive implementation of a subacute/rehabilitation care strategy in nursing homes, will be associated with superior performance. DATA SOURCES:Online Survey, Certification, and Reporting (OSCAR) data from 1997 to...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00649.x
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:To compare medical care costs and utilization in a consumer-driven health plan (CDHP) to other health insurance plans. STUDY DESIGN:We examine claims and employee demographic data from one large employer that adopted a CDHP in 2001. A quasi-experimental pre-post design is used to assign employees to three co...
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
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
abstract：OBJECTIVE:To develop and validate a disease-specific automated inpatient mortality risk adjustment system primarily using computerized numerical laboratory data and supplementing them with administrative data. To assess the values of additional manually abstracted data. METHODS:Using 1,271,663 discharges in 2000-2001,...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01126.x
更新日期：2010-12-01 00:00:00
abstract：OBJECTIVE:This study explores the impact of multiple-site practices on the distribution of physician services within a medical service region. DATA SOURCES AND STUDY SETTING:A questionnaire was mailed to all urologists (100 percent response rate) practicing in north central Connecticut (the Hartford medical service ar...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1993-10-01 00:00:00
abstract：OBJECTIVE:To study the impact of the number of choices and age on measures of performance in choosing a Medicare prescription drug plan. DATA SOURCE/STUDY SETTING:One hundred ninty-two healthy individuals age 18 and older, half age 65 or older, in Claremont, California. STUDY DESIGN:Participants were randomly assigne...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2009.00981.x
更新日期：2009-08-01 00:00:00
abstract：INTRODUCTION:America's community health centers (HCs) are uniquely poised to implement the patient-centered medical home (PCMH) model, as they are effective in providing comprehensive, accessible, and continuous primary care. This study aims to evaluate the relationship between PCMH recognition in HCs and clinical perf...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12523
更新日期：2017-06-01 00:00:00
abstract：OBJECTIVE:To examine the effect of post-hospital Medicare home health and informal care on the functional status of 755 Medicare beneficiaries six weeks after hospital discharge for treatment of stroke, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), hip procedures, and hip fractures. STU...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1998-08-01 00:00:00
abstract：OBJECTIVES:To examine variation in risk-adjusted reinsurance payments across Part D plans, analyze its implications for the program, and explore options to reduce reinsurance payments. DATA/STUDY DESIGN:2007-2015 Part D Plan Payment and Premium data; 2010-2013 Part D Prescription Drug Event data; and 2013 Part D Plan ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12866
更新日期：2018-12-01 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 effects of varying diagnostic and pharmaceutical criteria on the performance of claims-based algorithms for identifying beneficiaries with hypertension, heart failure, chronic lung disease, arthritis, glaucoma, and diabetes. STUDY SETTING:Secondary 1999-2000 data from two Medicare+Choice healt...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00321.x
更新日期：2004-12-01 00:00:00
abstract：OBJECTIVE:To determine whether (a) quality in schizophrenia care varies by race/ethnicity and over time and (b) these patterns differ across counties within states. DATA SOURCES:Medicaid claims data from California, Florida, New York, and North Carolina during 2002-2008. STUDY DESIGN:We studied black, Latino, and whi...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12296
更新日期：2015-10-01 00:00:00
abstract：OBJECTIVE:Our intention is to determine newborn costs and lengths of stay attributable to prenatal exposure to cocaine and other illicit drugs. DATA SOURCES AND STUDY SETTING:All parturients who delivered at a large municipal hospital in New York City between November 18, 1991 and April 11, 1992. STUDY DESIGN:A cross...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1995-06-01 00:00:00
abstract：OBJECTIVE:To examine the effect of Medicaid expansions on health insurance coverage and access to care among low-income adults with behavioral health conditions. DATA SOURCES/STUDY SETTING:Nine years (2004-2012) of individual-level cross-sectional data from a restricted-access version of National Survey on Drug Use an...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12411
更新日期：2015-12-01 00:00:00
abstract：OBJECTIVE:To examine the effect of rural hospital closures on the local economy. DATA SOURCES:U.S. Census Bureau, OSCAR, Medicare Cost Reports, and surveys of individuals knowledgeable about local hospital closures. STUDY DESIGN:Economic data at the county level for 1990-2000 were combined with information on hospita...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2005.00497.x
更新日期：2006-04-01 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
abstract：OBJECTIVE:To illustrate how the analysis of bimodal U-shaped distributed utilization can be modeled with beta-binomial regression, which is rarely used in health services research. DATA SOURCES/STUDY SETTING:Veterans Affairs (VA) administrative data and Medicare claims in 2001-2004 for 11,123 Medicare-eligible VA prim...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12055
更新日期：2013-10-01 00:00:00
abstract：:The concept of propensity to use ambulatory care is defined as the probability that a utilization occurs in a very small interval of time, given that no utilization has been observed before. With this definition of utilization, survival analysis can be used to assess the effect of a set of predictors on utilization. T...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1988-06-01 00:00:00
abstract：OBJECTIVE:The design of health insurance, and the role out-of-pocket (OOP) payments play in it, is a key policy issue as rising health costs have encouraged greater cost-sharing measures. This paper compares the percentage of Americans spending large amounts OOP to meet their health needs with percentages in eight othe...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12444
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVES:To examine the effects of changes in payment and risk adjustment on (1) the annual enrollment and switching behavior of Medicare Advantage (MA) beneficiaries, and (2) the relative costliness of MA enrollees and disenrollees. DATA:From 1999 through 2008 national Medicare claims data from the 5 percent longit...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12006
更新日期：2013-06-01 00:00:00
abstract：:Organizations are increasingly becoming dynamic and unstable. This evolution has given rise to greater reliance on teams and increased complexity in terms of team composition, skills required, and degree of risk involved. High-reliability organizations (HROs) are those that exist in such hazardous environments where t...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00566.x
更新日期：2006-08-01 00:00:00
abstract：OBJECTIVE:To test the effectiveness of financial incentives for smoking cessation in the Medicaid population. DATA SOURCES:Secondary data from the Medicaid Incentives for Prevention of Chronic Disease (MIPCD) program and Medicaid claims/encounter data from 2010 to 2015 for five states. STUDY DESIGN:Beneficiaries were...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12994
更新日期：2018-12-01 00:00:00
abstract：:The concepts of class, race, and ethnicity figure prominently in health services research in Britain. Occupational class has been employed for nearly a century to investigate social inequalities in health and access to care. More recently, researchers have identified differences in health status and utilization betwee...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1995-04-01 00:00:00
abstract：OBJECTIVE:Diabetes is a highly prevalent condition that results in substantial morbidity and premature mortality. We investigated how diabetes-associated mortality, disability, early retirement, and work absenteeism impacts workforce participation. DATA SOURCE:We used the Health and Retirement Study (HRS), a national ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00311.x
更新日期：2004-12-01 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
