Abstract：
OBJECTIVE:To examine the ways in which the costs of nonresidential mental health care depend on (1) the type of provider who initiates the treatment episode and (2) the level of cost sharing imposed on the patient. STUDY SETTING:The 1987 National Medical Expenditure Survey, a national probability sample of the U.S. civilian, noninstitutionalized population. DATA COLLECTION:Data were collected during four personal interviews conducted during 1987 and 1988. Key variables include the type of provider contacted at the beginning of treatment (psychiatrist, other physician, nonmedical mental health care specialist) and the cost (total actual payments from all sources) for the treatment episode. METHODS OF ANALYSIS:An episodic model of demand for mental health care is estimated using a two-step procedure. Multinomial probit analysis is first used to determine the factors that influence the choice of initial provider type. Right-censored Tobit analysis is used to determine the factors that affect the costs of care, including the type of provider who initiates the care episode. PRINCIPAL FINDINGS:Results indicate that out-of-pocket price does significantly (p < .05) affect the patient's initial choice of provider type but that, after controlling for the endogeneity of provider choice, price is no longer significant in explaining overall treatment costs. After controlling for selection effects, care episodes initiated by nonspecialist physicians are found to be as expensive as those initiated by psychiatrists and significantly more expensive than episodes initiated by nonphysicians. CONCLUSIONS:The results suggest that nonmedical mental health care specialists may be more effective than physicians in controlling costs when used as case managers in the care of persons with mental illnesses.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Holmes AM,Deb Psubject
Has Abstractpub_date
1998-12-01 00:00:00pages
1263-84issue
5 Pt 1eissn
0017-9124issn
1475-6773journal_volume
33pub_type
杂志文章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：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
doi：10.1111/1475-6773.13112
更新日期：2019-06-01 00:00:00
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
doi：10.1111/j.1475-6773.2004.00291.x
更新日期：2004-10-01 00:00:00
abstract：OBJECTIVE:To describe differences in patient experiences of hospital care by preferred language within racial/ethnic groups. DATA SOURCE:2014-2015 HCAHPS survey data. STUDY DESIGN:We compared six composite measures for seven languages (English, Spanish, Russian, Portuguese, Chinese, Vietnamese, and Other) within appl...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13105
更新日期：2019-02-01 00:00:00
abstract：OBJECTIVE:This study describes the derivation and validation of the Patient Management Category (PMC) Severity Scale, which provides a method of assessing the overall severity of a hospitalized patient's illnesses, based on the patient's unique clinical conditions, their interaction, and the resultant, combined risk of...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1994-08-01 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 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
doi：10.1111/1475-6773.13197
更新日期：2019-10-01 00:00:00
abstract：OBJECTIVE:To compare estimates of health coverage from the pre- and post- redesign of the Current Population Survey (CPS) Annual Social and Economic Supplement. DATA SOURCES/STUDY SETTING:The CPS 2013 Content Test. STUDY DESIGN:A test of the old and new CPS in which the control panel was a subset of the CPS productio...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12312
更新日期：2016-02-01 00:00:00
abstract：OBJECTIVE:To test for differences in patient outcomes when hospital and post-acute care (PAC) providers participate in accountable care organizations (ACOs). DATA/SETTING:Using Medicare claims, we examined changes in readmission, Medicare spending, and length of stay among patients admitted to ACO-participating hospit...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13023
更新日期：2018-12-01 00:00:00
abstract：BACKGROUND:In 2004, the State of Wisconsin introduced a change to their Medicaid Policy allowing medical care providers to be reimbursed for fluoride varnish treatment provided to Medicaid enrolled children. OBJECTIVE:To determine the extent by which a state-level policy change impacted access to fluoride varnish trea...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2009.00975.x
更新日期：2009-08-01 00:00:00
abstract：OBJECTIVE:To test the hypothesis that a greater commitment to strategic adaptation, as exhibited by more extensive implementation of a subacute/rehabilitation care strategy in nursing homes, will be associated with superior performance. DATA SOURCES:Online Survey, Certification, and Reporting (OSCAR) data from 1997 to...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00649.x
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:To compare safety climate between diverse U.S. hospitals and Veterans Health Administration (VA) hospitals, and to explore the factors influencing climate in each setting. DATA SOURCES:Primary data from surveys of hospital personnel; secondary data from the American Hospital Association's 2004 Annual Survey ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2009.00994.x
更新日期：2009-10-01 00:00:00
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：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：OBJECTIVE:To examine differences between the general medical and mental health specialty sectors in the expenditure and treatment patterns of aged and disabled Medicare beneficiaries with a physician diagnosis of psychiatric disorder. DATA SOURCES:Based on 1991-1993 Medicare Current Beneficiary Survey data, linked to ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1999-08-01 00:00:00
abstract：OBJECTIVE:To test the accuracy of various physicians' participation in Medicaid models. DATA SOURCES/STUDY SETTING:Primary data on 221 obstetricians and gynecologists in the Chicago area by telephone interviews over a four-month period. These data were combined with secondary data from the American Medical Association...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1997-08-01 00:00:00
abstract：RESEARCH OBJECTIVE:To assess the impact of recent Medicare prospective payment system (PPS) changes on efficiency in skilled nursing homes. DATA SOURCE/STUDY SETTING:Medicare Cost Reports (MCR), On-line Survey Certification and Reporting System (OSCAR), Area Resource Files (ARF), a Centers for Medicare and Medicaid Se...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00798.x
更新日期：2008-06-01 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:The rate of coronary artery bypass surgery (CABG) has been shown to vary greatly across geographic regions. This study examined whether these rates were associated with the rate of coronary artery angioplasty (PTCA) and with other community characteristics. DATA SOURCES/STUDY SETTING:The health care financin...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1995-08-01 00:00:00
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
doi：10.1111/j.1475-6773.2007.00754.x
更新日期：2008-02-01 00:00:00
abstract：OBJECTIVE:To determine factors associated with ruptured appendicitis among children, using administrative databases. Insurance-related differences in the risk of ruptured appendix among adults in California have previously been described (Braveman, Schaaf, Egerter, et al. 1994). DATA SOURCES/STUDY SETTING:State of Mar...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2001-04-01 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：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: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
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: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
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 determine how the addition of generalist care managers and collaborative information technology to an ambulatory team affects the care of patients with diabetes. STUDY SETTING:Multiple ambulatory clinics within Intermountain Health Care (IHC), a large integrated delivery network. STUDY DESIGN:A retrospec...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2005.00423.x
更新日期：2005-10-01 00:00:00
abstract：:Increasing numbers of Americans are living with multiple chronic conditions (MCCs) and disabilities. Addressing health care needs of persons with MCCs or disabilities presents challenges on many levels. For health services researchers, priorities include (1) considering MCCs and disabilities in comparative effectivene...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01145.x
更新日期：2010-10-01 00:00:00
abstract：OBJECTIVE:To assess optimal activity size/mix of Connecticut local public health jurisdictions, through estimating economies of scale/scope/specialization for environmental inspections/services. DATA SOURCES/STUDY SETTING:Connecticut's 74 local health jurisdictions (LHJs) must provide environmental health services, bu...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12740
更新日期：2017-12-01 00:00:00
