Abstract:
OBJECTIVE:This article tests whether or not the factors that affect hospital choice differ for selected subgroups of the population. DATA SOURCES:1985 California Office of Statewide Health Planning and Development (OSHPD) discharge abstracts and hospital financial data were used. STUDY DESIGN:Models for hospital choice were estimated using McFadden's conditional logit model. Separate models were estimated for high-risk and low-risk patients, and for high-risk and low-risk women covered either by private insurance or by California Medicaid. The model included independent variables to control for quality, price, ownership, and distance to the hospital. DATA EXTRACTION:Data covered all maternal deliveries in the San Francisco Bay Area in 1985 (N = 61,436). ICD-9 codes were used to classify patients as high-risk or low-risk. The expected payment code on the discharge abstract was used to identify insurance status. PRINCIPAL FINDINGS:The results strongly reject the hypothesis that high-risk and low-risk women have the same choice process. Hospital quality tended to be more important for high-risk than low-risk women. These results also reject the hypothesis that factors influencing choice of hospital are the same for women covered by private insurance as for those covered by Medicaid. Further, high-risk women covered by Medicaid were less likely than high-risk women covered by private insurance to deliver in hospitals with newborn intensive care units. CONCLUSIONS:The results show that the choice factors vary across several broadly defined subgroups of patients with a specific condition. Thus, estimates aggregating all patients may be misleading. Specifically, such estimates will understate actual patient response to quality of care indicators, since patient sensitivity to quality of care varies with the patients' risk status.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Phibbs CS,Mark DH,Luft HS,Peltzman-Rennie DJ,Garnick DW,Lichtenberg E,McPhee SJsubject
Has Abstractpub_date
1993-06-01 00:00:00pages
201-22issue
2eissn
0017-9124issn
1475-6773journal_volume
28pub_type
杂志文章abstract:OBJECTIVE:To determine if the incidence of psychiatric emergencies involving drugs or alcohol supports the argument that mentally ill persons contribute to elevated mortality during the days following disbursement of private earnings and public income transfers. STUDY DESIGN:Interrupted time-series using Box-Jenkins m...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2000-10-01 00:00:00
abstract::This article examines factors related to hospital closures, using a longitudinal sample of surviving and closed hospitals. The hospitals are drawn from three states with different regulatory programs. Size of hospital and occupancy rate are shown to be related to likelihood of closure, while ownership, length of stay,...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1983-01-01 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 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: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 test whether nonprofit, for-profit, or government hospital ownership affects medical service provision in rural hospital markets, either directly or through the spillover effects of ownership mix. DATA SOURCES/STUDY SETTING:Data are from the American Hospital Association, U.S. Census, CMS Healthcare Cost ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01280.x
更新日期:2011-10-01 00:00:00
abstract::This article analyzes three methods used to forecast the transition of long-term care clients through a variety of possible home and facility placements and levels of care. The test population (N = 1,653) is derived from the larger population of clients admitted in 1978 to British Columbia's newly established Long-Ter...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1985-10-01 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::All admissions to a 1,100-bed Department of Veterans Affairs (VA) hospital were screened to identify 171 terminally ill patients with informal caregivers who were then randomly assigned to VA hospital-based team home care (HBHC, N = 85) or customary care (N = 86). Patient functioning, and patient and caregiver morale ...
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:1992-02-01 00:00:00
abstract::Over a two-year interval, computerized tomography (CT) scans at an urban, 400-bed Department of Veterans Affairs medical center (VAMC) were obtained in three ways. First, an in-house low-efficiency machine was used. Then, scans were done at another area hospital, in effect duplicating some aspects of regionalizing ser...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVE:Building on the original taxonomy of hospital-based health systems from 20 years ago, we develop a new taxonomy to inform emerging public policy and practice developments. DATA SOURCES:The 2016 American Hospital Association's (AHA) Annual Survey; the 2016 IQVIA Healthcare Organizations and Systems (HCOS) dat...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13621
更新日期:2021-01-11 00:00:00
abstract:OBJECTIVE:To examine the effect of hospital volume on 30-day mortality for patients with congestive heart failure (CHF) using administrative and clinical data in conventional regression and instrumental variables (IV) estimation models. DATA SOURCES:The primary data consisted of longitudinal information on comorbid co...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2005.00461.x
更新日期:2006-02-01 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:To compare health care utilization between Canadian and U.S. residents. DATA SOURCES:Nationally representative 2007 surveys from the Medical Expenditure Panel Survey for the United States and the Canadian Community Health Survey for Canada. STUDY DESIGN:We use descriptive and multivariate methods to examine...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01466.x
更新日期:2013-04-01 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: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:Examine the impact of the 2011 shortage of the drug cytarabine on patient receipt and timeliness of induction treatment for Acute Myeloid Leukemia (AML). STUDY DESIGN:A retrospective cohort was utilized to examine odds of receipt of inpatient induction chemotherapy and time to first dose across major (N = 10...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13028
更新日期:2018-12-01 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 study used administrative data to identify the social determinants that have the greatest impact on Medicaid expenditures in adolescence. DATA SOURCES:Data were compiled using the Washington State Department of Social and Health Services Integrated Client Databases, which link data from state systems inc...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13052
更新日期:2019-02-01 00:00:00
abstract::Cost-benefit analyses are routinely included in evaluations of acute care programs. In the case of long-term care, it is frequently alleged that cost-benefit analysis cannot be fruitfully applied. This article demonstrates the utility of applying cost-benefit analysis to evaluations of long-term care programs. A case ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1981-04-01 00:00:00
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 ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVES:To test whether state Certificate of Need (CON) regulations influence procedural mortality or the provision of coronary artery bypass graft surgery (CABG) and percutaneous coronary interventions (PCI). DATA SOURCES:Medicare inpatient claims obtained for 1989-2002 for patients age 65+ who received CABG or PC...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2008.00933.x
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:We study the association between the timing of the Great Recession (GR) and health spending among uninsured adults distinguishing by citizenship/nativity status and time of U.S. residence. DATA SOURCE:Uninsured U.S. citizens and noncitizens from the 2005-2006 and 2008-2009 Medical Expenditure Panel Survey. ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12193
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:To examine whether physicians attend to gender prevalence data in diagnostic decision making for coronary heart disease (CHD) and to test the hypothesis that previously reported gender differences in CHD diagnostic certainty are due to discrimination arising from reliance on prevalence data ("statistical disc...
journal_title:Health services research
pub_type: 评论,杂志文章
doi:10.1111/j.1475-6773.2009.01022.x
更新日期:2009-12-01 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 examine the determinants of postsurgery length of stay (LOS) and inpatient mortality in the United States (California and Massachusetts) and Canada (Manitoba and Quebec). DATA SOURCES/STUDY SETTING:Patient discharge abstracts from the Agency for Health Care Policy and Research Nationwide Inpatient Sample ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To characterize the types of hospices with higher rates of patient disenrollment from the Medicare Hospice Benefit and the markets in which these hospices operate. DATA SOURCE:Secondary analyses of Surveillance, Epidemiology and End Results-Medicare data. Analyses included patients who died of cancer from 19...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2009.01002.x
更新日期:2009-12-01 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:OBJECTIVE:To determine the impact of rising health insurance premiums on coverage rates. DATA SOURCES & STUDY SETTING:Our analysis is based on two cohorts of nonelderly Americans residing in 64 large metropolitan statistical areas (MSAs) surveyed in the Current Population Survey in 1989-1991 and 1998-2000. Measures of...
journal_title:Health services research
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1475-6773.2005.00409.x
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:To assess the issue of nonrepresentative sampling in Medicare Advantage (MA) risk adjustment. DATA SOURCES:Medicare enrollment and claims data from 2008 to 2011. DATA EXTRACTION:Risk adjustment predictor variables were created from 2008 to 2010 Part A and B claims and the Medicare Beneficiary Summary File. ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13046
更新日期:2018-12-01 00:00:00