Abstract：
OBJECTIVES:In response to rising demand and increased costs for home care services for frail elderly and disabled Medicaid clients, New York City implemented cluster care, a shared-aide model of home care. Our objective: to evaluate the effects of cluster care on home care hours and costs, client functioning, depressive symptoms, and satisfaction. DATA SOURCES:Client interviews, conducted prior to implementation and again 16 months later; Medicaid claims records; home attendant payroll files; and vendor agency records. STUDY DESIGN:The study employed a pretest/posttest design, comparing 229 clients at the first seven demonstration sites to 175 clients at four comparison sites before and after cluster care implementation. Regression methods were used to analyze pre and post-intervention data. PRINCIPAL FINDINGS:Cluster care reduced costs by about 10 percent. Most savings occurred among the more vulnerable clients (those with five or more ADL/IADL limitations). Clients at cluster care sites who started out with fewer than five limitations appeared to decline somewhat more slowly than similarly impaired clients at comparison sites, while those with more than five ADL/IADLs tended to decline more rapidly. This difference was small-less than one limitation per year. Cluster care is associated with a significant decline in satisfaction but appears unrelated to depressive symptoms. CONCLUSIONS:Cluster care appears benign for home care clients with fewer limitations. For the more vulnerable, we recommend experimentation with low-cost interventions that might augment service and improve outcomes without reverting to traditional one-on-one care.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Feldman PH,Latimer E,Davidson Hsubject
Has Abstractpub_date
1996-10-01 00:00:00pages
489-508issue
4eissn
0017-9124issn
1475-6773journal_volume
31pub_type
杂志文章abstract：OBJECTIVE:To assess the effectiveness and cost-effectiveness of four treatment modalities for substance abuse. DATA SOURCES:The study used data from the Services Research Outcomes Study (SROS), a survey of 3,047 clients in a random sample of 99 drug treatment facilities across the United States. Detailed sociodemograp...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.00114
更新日期：2003-02-01 00:00:00
abstract：:One method used to determine utilization rates of cervical screening is women's self-report. Few studies have assessed the accuracy of this measure--none has been conducted in Australia--although there are a number of reasons for suspecting its validity. This study examined and quantified the accuracy of self-report o...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1991-04-01 00:00:00
abstract：OBJECTIVE:To simplify the decision-making process, we propose and implement an approach to assess the stability of health plan performance over time when multiple indicators of performance exist. DATA SOURCE:National Committee for Quality Assurance Health Care Effectiveness Data and Information Set data for childhood ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2008.00890.x
更新日期：2008-12-01 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：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:Our research compares health care use by Medicaid beneficiaries with that of the uninsured and the privately insured to measure the program's effect on access to care. DATA SOURCES/STUDY SETTING:Data include the 1987 National Medical Expenditure Survey and the Survey of Income and Program Participation for 1...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1996-02-01 00:00:00
abstract：OBJECTIVE:To evaluate the comparative safety of laparoscopic and open colectomy across surgeons varying in experience with laparoscopy. DATA SOURCES:National Medicare data (2008-2010) for beneficiaries undergoing laparoscopic or open colectomy. STUDY DESIGN:Using instrumental variable methods to address selection bia...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12482
更新日期：2017-02-01 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：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
abstract：OBJECTIVE:To test a conceptual model of relationships, reflection, sensemaking, and learning in primary care practices transitioning to patient-centered medical homes (PCMH). DATA SOURCES/STUDY SETTING:Primary data were collected as part of the American Academy of Family Physicians' National Demonstration Project of t...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12415
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVE:The volume and cost of services consumed by persons with AIDS (PWAs) during their last months of life are examined in this study. DATA SOURCES:This study utilizes data from the AIDS Costs and Service Utilization Survey (ACSUS). The ACSUS is the most comprehensive survey of medical services that are consumed ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1994-12-01 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:We evaluate the effects of the Nursing Home Quality Initiative (NHQI), which introduced quality measures to the Centers for Medicare and Medicaid Services' Nursing Home Compare website, on facility performance and consumer demand for services. DATA SOURCES:The nursing home Minimum Data Set facility reports f...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01298.x
更新日期：2011-12-01 00:00:00
abstract：STUDY QUESTION:Continuous quality improvement (CQI) has been implemented at least to some degree in many health care settings, yet randomized controlled trials (RCTs) of CQI are rare. We ask whether, when, and how RCTs of CQI might be designed. STUDY DESIGN:We consider two applications of CQI: as a general philosophy ...
journal_title：Health services research
pub_type： 评论,杂志文章
doi：
更新日期：2000-08-01 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：:The purpose of this study was to evaluate the applicability of a multiattribute utility model for measuring the severity of a patient's illness. A single medical problem (an analysis of the costs and benefits of different burn care systems) was used to test the model. Physicians estimated the relative importance of an...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1975-04-01 00:00:00
abstract：OBJECTIVE:To investigate how changes in insurer participation and composition as well as state policies affect health plan affordability for individual market enrollees. DATA SOURCES:2014-2019 Qualified Health Plan Landscape Files augmented with supplementary insurer-level information. STUDY DESIGN:We measured plan a...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13190
更新日期：2019-08-01 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：:The growth of unionization among hospital workers was sharply accelerated by the 1974 amendments to the National Labor Relations Act covering voluntary hospital workers. With continuing inflationary pressures in the hospital sector, the cost implications of the recent and projected growth of hospital unions is of some...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1984-12-01 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: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：:Uniform hospital discharge abstract data from Maryland were used to examine the homogeneity of trauma-related DRGs with respect to a well-established measure of injury severity, the Injury Severity Score (ISS). Thirty DRGs were identified as including trauma cases with a wide range of severity; for each of these DRGs,...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1991-04-01 00:00:00
abstract：OBJECTIVE:To discuss and quantify the incentives that Medicare managed care plans have to avoid (through selective enrollment or disenrollment) people who are at risk for very high costs, focusing on Medicare beneficiaries in the last year of life-a group that accounts for more than one-quarter of Medicare's annual exp...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00218.x
更新日期：2004-02-01 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：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
doi：10.1111/1475-6773.12680
更新日期：2018-04-01 00:00:00
abstract：STUDY QUESTIONS:To determine factors that distinguish effective rural hospital consortia from ineffective ones in terms of their ability to improve members' financial performance. Two questions in particular were addressed: (1) Do large consortia have a greater collective impact on their members? (2) Does a consortium'...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1999-04-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:In the last few years there has been a steady uptake of mobile phone short message service (SMS) reminders to increase medical attendance rates. We undertook a review of studies that assessed the effectiveness of SMS reminders at increasing the uptake of appointments in health care settings. ...
journal_title：Health services research
pub_type： 杂志文章,meta分析,评审
doi：10.1111/j.1475-6773.2011.01342.x
更新日期：2012-04-01 00:00:00
abstract：OBJECTIVES:To quantify racial and socioeconomic status (SES) disparities in oral health, as measured by tooth loss, and to determine the role of dental care use and other factors in explaining disparities. DATA SOURCES/STUDY SETTING:The Florida Dental Care Study, comprising African Americans (AAs) and non-Hispanic whi...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2003.00205.x
更新日期：2003-12-01 00:00:00
abstract：:In this research, we examine the relative importance of different structural units in a professional organization, the hospital, as they affect organizational effectiveness. The difficulties of measuring effectiveness in a complex professional organization are discussed, and an adjusted measure of surgical outcome is ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：OBJECTIVE:To quantify the impact of multiyear utilization of preventive dental services on downstream dental care utilization and expenditures for children. DATA SOURCES/STUDY SETTING:We followed 0.93 million Medicaid-enrolled children who were 3-6 years old in 2005 from 2005 to 2011. We used Medicaid claims data of A...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12811
更新日期：2018-10-01 00:00:00
