Practice setting and physician influences on judgments of colon cancer treatment by community physicians.


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.


Health Serv Res


Health services research


McFall SL,Warnecke RB,Kaluzny AD,Ford L


Has Abstract


1996-04-01 00:00:00












  • The combined effects of participatory styles of elderly patients and their physicians on satisfaction.

    abstract:OBJECTIVES:To test whether concordance or discordance of patient participation between patients and physicians is associated with higher satisfaction, and to examine the effects of patients' and physicians' participatory styles on patients' satisfaction with their physicians. DATA:Data collected in the Texas Tech 5000...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Xu KT

    更新日期:2004-04-01 00:00:00

  • Reliability of health belief indexes: confirmatory factor analysis in sex, race, and age subgroups.

    abstract::Despite frequent reference to the Health Belief Model (HBM), few studies address the internal consistency (within questionnaires) or the stability across populations of scales used to measure HBM variables. As part of a 1983 Michigan statewide blood pressure survey, trained interviewers administered 32 health belief q...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Weissfeld JL,Brock BM,Kirscht JP,Hawthorne VM

    更新日期:1987-02-01 00:00:00

  • Impact of Disease Prevalence Adjustment on Hospitalization Rates for Chronic Ambulatory Care-Sensitive Conditions in Germany.

    abstract:OBJECTIVES:To explore effects of disease prevalence adjustment on ambulatory care-sensitive hospitalization (ACSH) rates used for quality comparisons. DATA SOURCES/STUDY SETTING:County-level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Pollmanns J,Romano PS,Weyermann M,Geraedts M,Drösler SE

    更新日期:2018-04-01 00:00:00

  • Comparing the Cost of Care Provided to Medicare Beneficiaries Assigned to Primary Care Nurse Practitioners and Physicians.

    abstract:OBJECTIVE:This study is designed to assess the cost of services provided to Medicare beneficiaries by nurse practitioners (NPs) billing under their own National Provider Identification number as compared to primary care physicians (PCMDs). DATA SOURCE:Medicare Part A (inpatient) and Part B (office visit) claims for 20...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Perloff J,DesRoches CM,Buerhaus P

    更新日期:2016-08-01 00:00:00

  • Increasing health insurance costs and the decline in insurance coverage.

    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


    authors: Chernew M,Cutler DM,Keenan PS

    更新日期:2005-08-01 00:00:00

  • Beta-binomial regression and bimodal utilization.

    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


    authors: Liu CF,Burgess JF Jr,Manning WG,Maciejewski ML

    更新日期:2013-10-01 00:00:00

  • Physical rehabilitation following medicare prospective payment for skilled nursing facilities.

    abstract:OBJECTIVE:To examine the effect of the Medicare prospective payment system (PPS) for skilled nursing facilities (SNF) on the delivery of rehabilitation therapy to residents. DATA SOURCES:Resident-level data are based on the Resident Assessment Instrument Minimum Data Set for nursing facilities. All elderly residents a...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Wodchis WP

    更新日期:2004-10-01 00:00:00

  • The effect of pay-for-performance in nursing homes: evidence from state Medicaid programs.

    abstract:OBJECTIVE:Pay-for-performance (P4P) is commonly used to improve health care quality in the United States and is expected to be frequently implemented under the Affordable Care Act. However, evidence supporting its use is mixed with few large-scale, rigorous evaluations of P4P. This study tests the effect of P4P on qual...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Werner RM,Konetzka RT,Polsky D

    更新日期:2013-08-01 00:00:00

  • Parental beliefs and children's receipt of preventive care: another piece of the puzzle?

    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


    authors: Hughes SC,Wingard DL

    更新日期:2008-02-01 00:00:00

  • Will choice-based reform work for Medicare? Evidence from the Federal Employees Health Benefits Program.

    abstract:OBJECTIVE:. To examine the effect of premiums and benefits on the health plan choices of older enrollees who choose Federal Employees Health Benefits Program (FEHBP) health plans as their primary payer. DATA SOURCES:Administrative enrollment data from the Office of Personnel Management (OPM) and plan premiums and bene...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Florence CS,Atherly A,Thorpe KE

    更新日期:2006-10-01 00:00:00

  • Assessing treatment effects of inhaled corticosteroids on medical expenses and exacerbations among COPD patients: longitudinal analysis of managed care claims.

    abstract:OBJECTIVE:To assess costs, effectiveness, and cost-effectiveness of inhaled corticosteroids (ICS) augmenting bronchodilator treatment for chronic obstructive pulmonary disease (COPD). DATA SOURCES:Claims between 1997 and 2005 from a large managed care database. STUDY DESIGN:Individual-level, fixed-effects regression ...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Akazawa M,Stearns SC,Biddle AK

    更新日期:2008-12-01 00:00:00

  • Ecological analysis of the first generation of community clinical oncology programs.

    abstract:OBJECTIVE:An ecological framework is proposed for assessing factors important to consider in allocating funds to promote sound performance of interorganizational programs. DATA SOURCE/STUDY SETTING:This framework is used to examine the first generation of Community Clinical Oncology Programs (CCOPs) funded by the Nati...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Schopler JH

    更新日期:1993-04-01 00:00:00

  • Growing Reinsurance Payments Weaken Competitive Bidding in Medicare Part D.

    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


    authors: Jung J,Feldman R

    更新日期:2018-12-01 00:00:00

  • The effect of arthroscopic surgery of the knee on hospital utilization.

    abstract::Arthroscopic surgery of the knee has reduced in-hospital utilization of 37 percent for surgical treatment of internal derangements of the knee at The Mount Sinai Medical Center. In a study comparing arthrotomies of the knee in 1974 (N = 106) to arthroscopic surgery of the knee in 1984 (N = 221) it was found that while...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Pruzansky ME,Remer S,Freedman B

    更新日期:1989-12-01 00:00:00

  • The relationship between patients' perception of care and measures of hospital quality and safety.

    abstract:BACKGROUND:The extent to which patient experiences with hospital care are related to other measures of hospital quality and safety is unknown. METHODS; We examined the relationship between Hospital Consumer Assessment of Healthcare Providers and Systems scores and technical measures of quality and safety using service-...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Isaac T,Zaslavsky AM,Cleary PD,Landon BE

    更新日期:2010-08-01 00:00:00

  • Early impact of the implementation of Medicaid episode-based payment reforms in Arkansas.

    abstract:OBJECTIVE:To evaluate episode-based payments for upper respiratory tract infections (URI) and perinatal care in Arkansas's Medicaid population. STUDY SETTING:Upper respiratory infection and perinatal episodes among Medicaid-covered individuals in Arkansas and comparison states from fiscal year (FY) 2011 to 2014. STUD...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Toth M,Moore P,Tant E,Rutledge R,Beil H,Arbes S,West N,West SL

    更新日期:2020-08-01 00:00:00

  • Prescription drug monitoring programs: Assessing the association between "best practices" and opioid use in Medicare.

    abstract:OBJECTIVE:To estimate the impact of implementing prescription drug monitoring program (PDMP) best practices on prescription opioid use. DATA SOURCES:2007-2012 Medicare claims for noncancer pain patients, and PDMP attributes from the Prescription Drug Abuse Policy System. STUDY DESIGN:We derived PDMP composite scores ...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Moyo P,Simoni-Wastila L,Griffin BA,Harrington D,Alexander GC,Palumbo F,Onukwugha E

    更新日期:2019-10-01 00:00:00

  • The effect of assigning dedicated general practitioners to nursing homes.

    abstract:OBJECTIVE:To determine whether assigning a dedicated general practitioner (GP) to a nursing home reduces hospitalizations and readmissions. DATA SOURCES/STUDY SETTING:Secondary data on hospitalizations and deaths by month for the universe of nursing home residents in Denmark from January 2011 through February 2014. S...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Weatherall CD,Hansen AT,Nicholson S

    更新日期:2019-06-01 00:00:00

  • Spousal concordance in health behavior change.

    abstract:OBJECTIVE:This study examines the degree to which a married individual's health habits and use of preventive medical care are influenced by his or her spouse's behaviors. STUDY DESIGN:Using longitudinal data on individuals and their spouses, we examine changes over time in the health habits of each person as a functio...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Falba TA,Sindelar JL

    更新日期:2008-02-01 00:00:00

  • A two-compartment mixed-effects gamma regression model for quantifying between-unit variability in length of stay among children admitted to intensive care.

    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


    authors: Straney L,Clements A,Alexander J,Slater A,ANZICS Paediatric Study Group.

    更新日期:2012-12-01 00:00:00

  • Discontinuity of coverage for Medicaid and S-CHIP children at a transitional birthday.

    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


    authors: Ketsche P,Adams EK,Snyder A,Zhou M,Minyard K,Kellenberg R

    更新日期:2007-12-01 00:00:00

  • Hospital and geographic variability in thirty-day all-cause mortality following colorectal cancer surgery.

    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


    authors: Schootman M,Lian M,Pruitt SL,Deshpande AD,Hendren S,Mutch M,Jeffe DB,Davidson N

    更新日期:2014-08-01 00:00:00

  • The effects of predetermined payment rates for Medicare home healthcare.

    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


    authors: Brown R,Phillips B,Bishop C,Thornton C,Ritter G,Klein A,Schochet P,Skwara K

    更新日期:1997-10-01 00:00:00

  • Mobile technology in rural hospitals: the case of the CT scanner.

    abstract:OBJECTIVE:This study evaluates the relationship between hospital and regional characteristics and the prevalence of mobile computed tomography in rural hospitals. DATA SOURCES AND STUDY SETTING:Primary data were gathered from all rural hospitals in eight northwestern states (n = 471) in 1991. Secondary data sources in...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Hartley D,Moscovice I,Christianson J

    更新日期:1996-06-01 00:00:00

  • Factors related to Medicaid payment acceptance at outpatient substance abuse treatment programs.

    abstract:OBJECTIVE:To examine factors associated with Medicaid acceptance for substance abuse (SA) services by outpatient SA treatment programs. DATA SOURCES:Secondary analysis of 2003-2006 National Survey of Substance Abuse Treatment Services data combined with state Medicaid policy and usage measures and other publicly avail...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Terry-McElrath YM,Chriqui JF,McBride DC

    更新日期:2011-04-01 00:00:00

  • Effect of Massachusetts health reform on chronic disease outcomes.

    abstract:OBJECTIVE:To determine whether Massachusetts Health Reform improved health outcomes in uninsured patients with hyperlipidemia, diabetes, or hypertension. DATA SOURCE:Partners HealthCare Research Patient Data Registry (RPDR). STUDY DESIGN:We examined 1,463 patients with hyperlipidemia, diabetes, or hypertension who we...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Stryjewski TP,Zhang F,Eliott D,Wharam JF

    更新日期:2014-12-01 00:00:00

  • How do proxy responses and proxy-assisted responses differ from what Medicare beneficiaries might have reported about their health care?

    abstract:OBJECTIVE:Assess proxy respondent effects on health care evaluations by Medicare beneficiaries. DATA SOURCE:110,215 respondents from the nationally representative 2001 CAHPS((R)) Medicare Fee-for-Service Survey. STUDY DESIGN/DATA COLLECTION/EXTRACTION METHODS:We compare the effects of both proxy respondents and proxy...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Elliott MN,Beckett MK,Chong K,Hambarsoomians K,Hays RD

    更新日期:2008-06-01 00:00:00

  • State Prescription Contraception Insurance Mandates: Effects on Unintended Births.

    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


    authors: Johnston EM,Adams EK

    更新日期:2017-12-01 00:00:00

  • Experiences of Agency for Healthcare Research and Quality-funded projects that implemented practices for safer patient care.

    abstract:OBJECTIVES:To synthesize lessons learned from the experiences of Agency for Healthcare Research and Quality-funded patient safety projects in implementing safe practices. DATA SOURCES:Self-reported data from individual and group interviews with Original, Challenge, and Partnerships in Implementing Patient Safety (PIPS...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Taylor SL,Ridgely MS,Greenberg MD,Sorbero ME,Teleki SS,Damberg CL,Farley DO

    更新日期:2009-04-01 00:00:00

  • Impact of administrative technology on acute care bed need.

    abstract::This article reports an evaluation of the impact of three administrative technologies--Admission Scheduling (AS) Systems, Outpatient Surgery (OPS) Programs, and Preadmission Testing (PAT) Programs--on the number of acute care beds required by a hospital. The evaluation mechanism reported here is called the ADTECH Comp...

    journal_title:Health services research

    pub_type: 杂志文章


    authors: Martin JB,Dahlstrom GA,Johnston CM

    更新日期:1985-04-01 00:00:00