Abstract:
OBJECTIVE:This article compares judgments about the treatment of Dukes' B2 and C colon cancer made by general surgeons to those of internists and family practitioners. Physician and practice variables were specialty, affiliation with a Community Clinical Oncology Program (CCOP) hospital, time in practice, professional centrality (level of participation in cancer information networks), solo practice, and number of colon cancer patients. DATA COLLECTION METHODS:Data are combined from national probability samples of CCOP- and non-CCOP-affiliated physicians. This study focused on 1,138 internists, family physicians, and general surgeons who participated in decision making for patients diagnosed with Dukes' B2 or C stage colon cancer. Judgments were elicited using brief vignettes. METHODS OF ANALYSIS:Judgments of adjuvant therapy are classified as (a) consistent with the National Institutes of Health Consensus Conference recommendations (experimental for Dukes' B2, accepted for Dukes' C); (b) accepted treatment for both stages; or (c) experimental for both stages. Multinomial logit analyses were used to examine the association of practice setting and physician characteristics to judgments of treatment. RESULTS:Surgeons and CCOP-affiliated physicians were more likely to endorse the NIH consensus conference position. Surgeons, younger physicians, and those in group practice were more likely to approve of chemotherapy for both cancer stages. The most common position (chemotherapy experimental) was more likely from nonsurgeons, solo practitioners, and non-CCOP physicians. CONCLUSION:Physician and practice setting characteristics, including organized structures such as the CCOP, are possible mediating structures that can facilitate dissemination of standards of treatment.
journal_name
Health Serv Resjournal_title
Health services researchauthors
McFall SL,Warnecke RB,Kaluzny AD,Ford Lsubject
Has Abstractpub_date
1996-04-01 00:00:00pages
5-19issue
1eissn
0017-9124issn
1475-6773journal_volume
31pub_type
杂志文章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: hospit...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:To describe how the organization and dynamics of health systems changed between 1999 and 2001, in the context of expectations from the mid-1990s when managed care was in ascendance, and assess the implications for consumers and policymakers. DATA SOURCES/STUDY SETTING:Data are from the Community Tracking Stu...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00119
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To assess the influence of relational climate on quality of diabetes care. DATA SOURCES/STUDY SETTING:The study was conducted at the Department of Veterans Affairs (VA). The VA All Employee Survey (AES) was used to measure relational climate. Patient and facility characteristics were gathered from VA adminis...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12675
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To compare standardized estimates of the true resource costs of outpatient health care to the allowable and billed charges for that care among Medicare Fee for Service (FFS) beneficiaries. DATA SOURCES/STUDY SETTING:Medicare Carrier and Outpatient Standard Analytic (SAF) files linked to participant data in t...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12318
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:To quantify between-unit variability in mean length of stay (LoS) between intensive care units (ICUs) after adjusting for differences in case mix using a method that does not require arbitrary trimming of data. SETTING:An analysis of registry data from pediatric ICUs (PICUs) in Australia and New Zealand. ST...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2012.01421.x
更新日期:2012-12-01 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:OBJECTIVE:To examine the implications of serious and chronic health problems on the willingness of enrollees to switch health plans if they are dissatisfied with their current arrangements. DATA SOURCE:A large (20,283 respondents) survey of employees of three national corporations committed to the model of managed com...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1999-06-01 00:00:00
abstract::We examined the effect of the Delphi iteration procedure in developing explicit criteria for ambulatory care assessment. Practicing internists chose items they believed to be essential with regard to the care of certain specified conditions. The initial responses were tabulated and "fed-back" to the participants. The ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract::Two indexes are described, based on measures of administrative effectiveness and patient care effectiveness. The measures used were selected and ranked by a Delphi panel from a list of 30 measures drawn from the literature. Weights were assigned by the panel to 19 selected measures. The resulting indexes did well in a...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1976-10-01 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:The objective of this study was to assess nonresponse error in telephone health survey data based on an address-based sample. DATA SOURCES:Telephone and in-person interviews in Greater Boston. STUDY DESIGN/DATA COLLECTION:Interviewers attempted telephone interviews at addresses that were matched to telephon...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13110
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To assess the extent and consistency of geographic differences in the use of post-acute care (PAC), and the stability of this pattern of variation. DATA SOURCES:The 5 percent Medicare data sample for 1996, 1997, and the first eight months of 1998 were used. STUDY DESIGN:Patterns of PAC use for various Diagn...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.00043
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:Evaluate the association between opioid therapy and health-related quality of life (HRQoL) in participants with chronic, noncancer pain (CNCP). DATA SOURCES:Medical Expenditure Panel Survey Longitudinal, Medical Conditions, and Prescription Files. STUDY DESIGN:Using a retrospective cohort study design, the ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12836
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:This paper analyzes whether the rise in managed care during the 1990s caused the increase in hospital concentration. DATA SOURCES:We assemble data from the American Hospital Association, InterStudy and government censuses from 1990 to 2000. STUDY DESIGN:We employ linear regression analyses on long differenc...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00601.x
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To compare the performance of various risk adjustment models in behavioral health applications such as setting mental health and substance abuse (MH/SA) capitation payments or overall capitation payments for populations including MH/SA users. DATA SOURCES/STUDY DESIGN:The 1991-93 administrative data from the...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:To assess the association between aggregate unemployment and hospital discharges for acute myocardial infarction (AMI) among adults and seniors, 1995-2011. DATA SOURCES/STUDY SETTING:Community hospital discharge data from states collected for the Healthcare Cost and Utilization Project (HCUP) State Inpatient...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12298
更新日期:2015-10-01 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 effect of worker heterogeneity, firm size, and establishment size on the breadth of employer health insurance offerings. DATA SOURCES:The data were drawn from the 1993 Robert Wood Johnson Foundation Employer Health Insurance Survey of 22,000 business establishments selected randomly from ten s...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:To examine the influence of place of graduate medical education (GME), state licensure requirements, presence of established international medical graduates (IMGs), and ethnic communities on the initial practice location choices of new IMGs. DATA SOURCES:The annual Graduate Medical Education (GME) Survey of ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1034/j.1600-0560.2002.58.x
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:To identify patient characteristics and health care experiences associated with primary care linkage after alcohol or drug detoxification. DATA SOURCES/STUDY SETTING:Primary data collected over two years. Subjects were adults without primary medical care, in an urban residential detoxification program. STUD...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00246.x
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVE:To demonstrate how expanding services covered by a "bundled payment" can also expand variation in the costs of treating patients under the bundle, using the Medicare dialysis program as an example. DATA SOURCES/STUDY SETTING:Observational claims-based study of 197,332 Medicare hemodialysis beneficiaries enro...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12202
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:The Standard Gamble (SG) technique is recommended for measurement of individuals' preferences under uncertainty and to express the outcome of different therapeutic choices in utility values to be used in clinical decision analysis and health program evaluation. The article alerts users of this technique to pr...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVE:Independent freestanding emergency departments (IFEDs) have proliferated over the last decade, largely in Texas. We examined the IFED physician workforce composition and changes in emergency physician workforce supply across states and in rural Texas over the period of IFED proliferation following a 2009 legi...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13587
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To develop and test a new outcome measure, Conditional Length of Stay (CLOS), to assess hospital performance when deaths are rare and complication data are not available. DATA SOURCES:The 1991 and 1992 MedisGroups National Comparative Data Base. STUDY DESIGN:We use engineering reliability theory traditional...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:To understand reasons why California has lower Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores than the rest of the country, including differing patterns of CAHPS scores between Medicare Advantage (MA) and fee-for-service, effects of additional demographic characteristics of beneficiari...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01279.x
更新日期:2011-10-01 00:00:00
abstract::De-hospitalization of cancer treatment, particularly for those with advanced disease, can complicate adjustment and strain the capacity of caregiver networks to meet patients' daily needs. Outpatient staff should be able to recognize patients who need help to meet their daily needs as well as those who are not getting...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1992-08-01 00:00:00
abstract::Mr. Zamberlan is one of seven major executives in the Department of Veterans Affairs (VA) Veterans Health Services and Research Administration (VHS&RA), directing health care in a five-state region that includes 21 medical centers, 7 outpatient clinics, and 19 veterans outreach centers. As a medical center director in...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVE:To decompose the change in pediatric and adult dental care utilization over the last decade. DATA:2001 through 2010 Medical Expenditure Panel Survey. STUDY DESIGN:The Blinder-Oaxaca decomposition was used to explain the change in dental care utilization among adults and children. Changes in dental care util...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12130
更新日期:2014-04-01 00:00:00
abstract::This article examines forces that influence physicians to change the percentage of their admissions to a hospital (loyalty) and to cease admitting patients to a hospital altogether (exit). Because physicians are both members of a hospital and consumers of its services, their admitting patterns can be described using m...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the role of health plan benefit design and price on consumers' decisions to purchase health insurance in the nongroup market and their choice of plan. DATA SOURCES AND STUDY SETTING:Administrative data from the three largest nongroup insurers in California and survey data about those insured in t...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2007.00726.x
更新日期:2007-12-01 00:00:00