Abstract:
:Using a sample of 3,000 urban hospitals, this article examines the contributions of selected hospital characteristics to variations in hospital technical efficiencies, while it accounts for multiple products and inputs, and controls for local environmental variations. Four hospital characteristics are examined: hospital size, membership in a multihospital system, ownership, and payer mix (managed care contracts, percent Medicare, and percent Medicaid). Ownership and percent Medicare are consistently found to be related significantly to hospital efficiency. Within the ownership variable, government hospitals tend to be more efficient and for-profit hospitals less efficient than other hospitals. Higher percentages of Medicare payment are negatively related to efficiency. While not consistently significant across all five of the MSA size categories in which the analyses are conducted, possession of managed care contracts, membership in a multihospital system, and size all are consistently related positively to hospital technical efficiency. These variables are also all significant when the hospitals are examined in a combined analysis. Percent Medicaid was not significant in any of the analyses. Implications for policy and the need for methodological work are discussed.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Ozcan YA,Luke RDsubject
Has Abstractpub_date
1993-02-01 00:00:00pages
719-39issue
6eissn
0017-9124issn
1475-6773journal_volume
27pub_type
杂志文章abstract:BACKGROUND:Patients are treated using observation services (OS) when their care needs exceed standard outpatient care (i.e., clinic or emergency department) but do not qualify for admission. Medicare and other private payers seek to limit this care setting to 48 hours. DATA SOURCE/STUDY SETTING:Healthcare Cost and Uti...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12143
更新日期:2014-06-01 00:00:00
abstract:RESEARCH OBJECTIVE:This study examines small area variations in readmission rates to assess whether higher readmission rate in an area is associated with higher clusters of patients with multiple chronic conditions. STUDY DESIGN:The study uses hospital discharge data of adult (18+) patients in 6 U.S. states for 2009 f...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12401
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To compare utilization and preventive care receipt among patients of federal Section 330 health centers (HCs) versus patients of other settings. DATA SOURCES:A nationally representative sample of adults from the Medical Expenditure Panel Survey (2004-2008). STUDY DESIGN:HC patients were defined as those wit...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12178
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:To utilize functional status (FS) outcomes to benchmark outpatient therapy clinics. DATA SOURCES:Outpatient therapy data from clinics using Focus on Therapeutic Outcomes (FOTO) assessments. STUDY DESIGN:Retrospective analysis of 538 clinics, involving 2,040 therapists and 90,392 patients admitted July 2006-...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12344
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:Apply quantile regression for a high-resolution analysis of changes in wait time to treatment and assess its applicability to quality improvement data compared with least-squares regression. DATA SOURCE:Addiction treatment programs participating in the Network for the Improvement of Addiction Treatment. MET...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01436.x
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:To examine whether disparities in health care experiences of Medicare beneficiaries differ between managed care (Medicare Advantage [MA]) and traditional fee-for-service (FFS) Medicare. DATA SOURCES:132,937 MA and 201,444 FFS respondents to the 2007 Medicare Consumer Assessment of Health Care Providers and S...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01245.x
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:To compare different methods for defining screening mammograms with Medicare claims and their impact on estimates of breast cancer screening rates. METHODS:Medicare outpatient facility and physician claims for 61,962 women in 1993 and 59,652 women in 1998 were reviewed for evidence of receipt of screening m...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.10912
更新日期:2002-12-01 00:00:00
abstract:RESEARCH OBJECTIVE:To investigate disenrollment from public insurance at the 6-year transitional birthday when eligibility for many children moves from Medicaid to State Children's Health Insurance Program (S-CHIP). DATA SOURCES:Data from Georgia's S-CHIP (PeachCare) and Medicaid programs from 2000 to 2002. STUDY DES...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00795.x
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:To demonstrate the value of shrinkage estimators when calculating a composite quality measure as the weighted average of a set of individual quality indicators. DATA SOURCES:Rates of 28 quality indicators (QIs) calculated from the minimum dataset from residents of 112 Veterans Health Administration nursing h...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01437.x
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:To evaluate whether community-based health insurance (CBHI) protects household assets in rural Burkina Faso, Africa. DATA SOURCES:Data were used from a household panel survey that collected primary data from randomly selected households, covering 41 villages and one town, during 2004-2007(n = 890). STUDY DE...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01321.x
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVES:Eight grant teams used Agency for Healthcare Research and Quality infrastructure development research grants to enhance the clinical content of and improve race/ethnicity identifiers in statewide all-payer hospital administrative databases. PRINCIPAL FINDINGS:Grantees faced common challenges, including recr...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12330
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:To examine the impact of mandatory HMO enrollment for Medicaid-covered pregnant women on prenatal care use, smoking, Cesarean section (C-section) use, and birth weight. DATA SOURCES/STUDY SETTING:Linked birth certificate and Medicaid enrollment data from July 1993 to June 1998 in 10 Ohio counties, 6 that imp...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00260.x
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:Racial and ethnic disparities in health and health care have been documented; the elimination of such disparities is currently part of a national agenda. In order to meet this national objective, it is necessary that measures identify accurately the true prevalence of the construct of interest across diverse...
journal_title:Health services research
pub_type: 杂志文章,评审
doi:10.1111/j.1475-6773.2005.00450.x
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:To assess the value of a novel composite measure for identifying the best hospitals for major procedures. DATA SOURCE:We used national Medicare data for patients undergoing five high-risk surgical procedures between 2005 and 2008. STUDY DESIGN:For each procedure, we used empirical Bayes techniques to create...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01407.x
更新日期:2012-10-01 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 develop a scale to measure patients' trust in health insurers, including public and private insurers and both indemnity and managed care. A scale was developed based on our conceptual model of insurer trust. The scale was analyzed for its factor structure, internal consistency, construct validity, and othe...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVES:To provide updated estimates of narrow- and broad-spectrum antibiotic use among U.S. children. DATA SOURCES:Linked nationally representative data from the 2004-2010 Medical Expenditure Panel Survey Household Component and the 2000 Decennial Census. STUDY DESIGN:Relationships between individual-, family-, a...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12260
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:To investigate disparities in mental health care episodes, aligning our analyses with decisions to start or drop treatment, and choices made during treatment. STUDY DESIGN:We analyzed whites, blacks, and Latinos with probable mental illness from Panels 9-13 of the Medical Expenditure Panel Survey, assessing ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12095
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To assess the effects of an alternative method of paying home health agencies for services to Medicare beneficiaries, based on a demonstration program. DATA SOURCES/STUDY SETTING:Primary and secondary data collected on participating home health agencies in five states and their patients during the three-year...
journal_title:Health services research
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:To assess hospital and geographic variability in 30-day mortality after surgery for CRC and examine the extent to which sociodemographic, area-level, clinical, tumor, treatment, and hospital characteristics were associated with increased likelihood of 30-day mortality in a population-based sample of older CRC...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12171a
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:To use statistical process control charts to monitor in-hospital outcomes at the hospital level for a wide range of procedures and diagnoses. DATA SOURCES:Routine English hospital admissions data. STUDY DESIGN:Retrospective analysis using risk-adjusted log-likelihood cumulative sum (CUSUM) charts, comparing...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00742.x
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:To develop and test a caregiver-reported experience measure for pediatric hospital-to-home transitions. DATA SOURCES/STUDY SETTING:Primary data were collected between 07/2014 and 05/2015 from caregivers within 2-8 weeks of their child's discharge from a tertiary care children's hospital. STUDY DESIGN/DATA C...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12864
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of the Nursing Home Value-Based Purchasing demonstration on quality of care and Medicare spending. DATA SOURCES/STUDY SETTING:Administrative and qualitative data from Arizona, New York, and Wisconsin nursing homes over the base-year (2008-2009) and 3-year (2009-2012) demonstration peri...
journal_title:Health services research
pub_type: 杂志文章,随机对照试验
doi:10.1111/1475-6773.12538
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:The case mix-adjusted pattern of use of health care services, especially posthospital care, is compared before and after the introduction of Medicare's Prospective Payment System (PPS). DATA SOURCES:The 1982 and 1984 National Long Term Care Surveys (NLTCS) linked to Medicare administrative records 1982-1986 ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1993-08-01 00:00:00
abstract:OBJECTIVE:To examine the benefits of a high-performance work environment (HPWE) for employees, patients, and hospitals. STUDY SETTING:Forty-five adult, medical-surgical units in nine hospitals in upstate New York. STUDY DESIGN:Cross-sectional study. DATA COLLECTION:Surveys were collected from 1,527 unit-based hospit...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01438.x
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:To examine the relationship between features of managed care organizations (MCOs) and health care use patterns by children. DATA SOURCES:Telephone survey data from 2,223 parents of children with special health care needs, MCO-administrator interview data, and health care claims data. STUDY DESIGN:Cross-sect...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2003.00195.x
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:To examine trends in employer-sponsored health insurance coverage rates and its associated components between 2000 and 2008, to provide a baseline for later evaluations of the Affordable Care Act, and to provide information to policy makers as they design the implementation details of the law. DATA SOURCES:P...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01368.x
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To test the effects of state prescription contraception insurance mandates on unintended, mistimed, and unwanted births in a sample of privately insured recent mothers. DATA:We pooled Pregnancy Risk Assessment Monitoring System (PRAMS) data from 1997 to 2012 to study 209,964 privately insured recent mothers ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12792
更新日期:2017-12-01 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 investigate the role of smoking cessation in body weight. DATA SOURCES:2004-2005 and 2009-2010 Behavioral Risk Factor Surveillance Surveys (BRFSS) (N = 349,000), Centers for Disease Control and Prevention; Tax Burden on Tobacco (Orzechowski and Walker 2010). STUDY DESIGN:The Gaussian treatment effect mod...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01380.x
更新日期:2012-08-01 00:00:00