abstract：OBJECTIVES:The authors evaluate a measure of the validity of utility elicitations and study the potential effects of invalid elicitations on population utility values. METHODS:The authors used a computerized survey to describe and measure preferences for three common side-effects of anti-psychotic drugs (tardive dyski...

journal_title：Medical care

authors： Lenert LA,Morss S,Goldstein MK,Bergen MR,Faustman WO,Garber AM

更新日期：1997-09-01 00:00:00

abstract：OBJECTIVES:Adverse outcome rates are increasingly used as yardsticks for the quality of hospital care. However, the validity of many outcome studies has been undermined by the application of one outcome to all patients in large, diagnostically diverse populations, many of which lack evidence of a link between anteceden...

journal_title：Medical care

authors： Wray NP,Peterson NJ,Souchek J,Ashton CM,Hollingsworth JC

更新日期：1997-08-01 00:00:00

abstract：OBJECTIVES:This study investigates the use of data from automated systems within a large managed care plan to create indicators of clinical quality. METHODS:Measures from the first year of Health Plan Employer Data and Information Set, HEDIS 2.0, are used to compare chart review and automated analysis methodologies. T...

journal_title：Medical care

authors： Dresser MV,Feingold L,Rosenkranz SL,Coltin KL

更新日期：1997-06-01 00:00:00

abstract：:Geriatric rehabilitation is a multidisciplinary set of evaluative, diagnostic, and therapeutic interventions whose purpose is to restore functional ability or enhance residual functional capability in elderly people with disabling impairments. The Boston Working Group on Improving Health Care Outcomes Through Geriatri...

journal_title：Medical care

authors：

更新日期：1997-06-01 00:00:00

abstract：OBJECTIVES:The authors compare the extent and nature of triazolam use before and after its deletion from a health maintenance organization's (HMO) open and advisory-type drug formulary. METHODS:Benzodiazepine dispensings of HMO members were collected for the 3 years before (1989-1991) and for the 2 years after (1992-1...

journal_title：Medical care

authors： Johnson RE,McFarland B,Woodson GT

更新日期：1997-04-01 00:00:00

abstract：OBJECTIVES:Medicare hospitalizations involve both facility and physician services. Although several studies analyze hospital-level variations in Medicare inpatient facility and inpatient physician services per admission, few studies directly explore the relationship between these services. Theoretically, inpatient faci...

journal_title：Medical care

authors： Miller ME,Welch WP,Wong HS

更新日期：1997-02-01 00:00:00

abstract：OBJECTIVES:Use of antepartum tests of fetal well-being is widespread even though effectiveness in preventing fetal damage or stillbirth has not been established. The study objective was to examine whether aggressive use of these tests might contribute to increased rates of other birth outcomes, including low birth weig...

journal_title：Medical care

authors： Helfand M,Zimmer-Gembeck MJ

更新日期：1997-01-01 00:00:00

abstract：OBJECTIVES:Various individual characteristics increase a nursing home resident's likelihood of being mechanically restrained. However, there is not good information on the role played by facility characteristics and geographic area in determining the likelihood of physical restraint use. This study investigates the imp...

journal_title：Medical care

authors： Phillips CD,Hawes C,Mor V,Fries BE,Morris JN,Nennstiel ME

更新日期：1996-11-01 00:00:00

abstract：OBJECTIVES:Reliability and validity are as necessary for predrafted advance directive forms as they are for all clinical assessment instruments. Performance of predrafted advance directive forms with both lay persons and clinicians is relevant. Evidence relating to test- retest reliability, content validity, and criter...

journal_title：Medical care

authors： Alpert HR,Hoijtink H,Fischer GS,Emanuel L

更新日期：1996-10-01 00:00:00

abstract：OBJECTIVES:The authors study the relationship between people's sense of community and problems they experience with the health-care system, specifically problems related to cost, access, provider choice, and satisfaction. METHODS:Data from a 1993 Florida poll (n = 1202) was used to conduct a multinomial logit analysis...

journal_title：Medical care

authors： Ahern MM,Hendryx MS,Siddharthan K

更新日期：1996-09-01 00:00:00

abstract：OBJECTIVES:The authors examined organizational characteristics of 16 primary care group practices to determine their influence on quality or quality improvement. METHODS:The authors used a data base compiled during a randomized, controlled trial of quality assurance interventions consisting of measures of guideline-re...

journal_title：Medical care

authors： Hargraves JL,Palmer RH,Orav EJ,Wright EA

更新日期：1996-09-01 00:00:00

abstract：OBJECTIVES:Individuals without health insurance in general receive fewer health services and are more likely than insured patients to experience poor outcomes. The main goal of this research was to study whether physicians' clinical recommendations vary for insured and uninsured patients, implying that physicians' choi...

journal_title：Medical care

authors： Mort EA,Edwards JN,Emmons DW,Convery K,Blumenthal D

更新日期：1996-08-01 00:00:00

abstract：:The authors assess the factorial validity of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) for use in a clinical sample of disadvantaged, older adults with significant comorbidities. Confirmatory factor analysis was performed using LISREL VIII on data obtained from baseline face-to-face interview...

journal_title：Medical care

authors： Wolinsky FD,Stump TE

更新日期：1996-06-01 00:00:00

abstract：:The measurement of inpatient complications his received substantial attention in recent years because mortality rates and other outcome measures often appear unable to discriminate superior from inferior hospital care. Complication measurement holds out the promise of being more sensitive to variations in patient care...

journal_title：Medical care

authors： Brailer DJ,Kroch E,Pauly MV,Huang J

更新日期：1996-05-01 00:00:00

abstract：:This article examines changes in the service mix of California hospitals as part of their response to shifts in the system of reimbursement between 1983 and 1988. The Hospital Discharge Data Set and the Annual Hospital Disclosure Report produced by California Office of Statewide Health Planning and Development were us...

journal_title：Medical care

authors： Zwanziger J,Melnick GA,Simonson L

更新日期：1996-04-01 00:00:00

abstract：:This study compares health insurance payments and patient utilization patterns for episodes of care for common lumbar and low back conditions treated by chiropractic and medical providers. Using 2 years of insurance claims data, this study examines 6,183 patients who had episodes with medical or chiropractic first-con...

journal_title：Medical care

authors： Stano M,Smith M

更新日期：1996-03-01 00:00:00

abstract：:Many health care system, including that of the Department of Veterans Affairs (VA), are facing dramatic changes as they adapt to state-level reform legislation and move into managed care environments. As new costing systems are designed and as researchers seek to conduct cost-effectiveness studies to guide health poli...

journal_title：Medical care

authors： Swindle RW Jr,Beattie MC,Barnett PG

更新日期：1996-03-01 00:00:00

abstract：:Health-related quality-of-life (HRQOL) measures are becoming increasingly important for evaluating the effectiveness of medical interventions and assessing the health of populations. Preference-based instruments, a subset of HRQOL measures, allow comparisons of overall health status in populations and in clinical sett...

journal_title：Medical care

authors： Gold M,Franks P,Erickson P

更新日期：1996-02-01 00:00:00

abstract：:One widely discussed response to the severe problems faced by many rural hospitals is to convert them into organizations that provide health services other than general, acute inpatient care. This study identifies conversions that occurred nationally from 1984 to 1991. The study also empirically examines the determina...

journal_title：Medical care

authors： Alexander JA,D'Aunno TA,Succi MJ

更新日期：1996-01-01 00:00:00

abstract：:The evaluation of long-term care demonstrations has to deal with complex organizational entities, with large, heterogeneous client populations that, during the course of study, may have to change features of their organization or operation. The implications of such "real-time" changes are discussed for analyses of the...

journal_title：Medical care

authors： Manton KG,Newcomer R,Lowrimore GR,Vertrees JC,Harrington C

更新日期：1995-12-01 00:00:00

abstract：:A population-based approach was used to analyze the utilization patterns of hospital care by Manitoba residents during the fiscal year 1991/1992. Patterns were analyzed for eight administrative regions, with use assigned to the patient's region of residence, regardless of the location of the hospitalization. Regional ...

journal_title：Medical care

authors： Black CD,Roos NP,Burchill CA

更新日期：1995-12-01 00:00:00

abstract：:One of the techniques adopted recently by certain hospitals to meet the competitive pressure for reducing costs is physician profiling. Profiling produces periodic reports that compare a physician's resource consumption to a benchmark figure. This study analyzes the effectiveness and implications of one hospital's int...

journal_title：Medical care

authors： Evans JH 3rd,Hwang Y,Nagarajan N

更新日期：1995-11-01 00:00:00

abstract：:This article reports on a study of the labor efficiency of 461 nursing homes located in Pennsylvania. Data envelopment analysis was used to estimate efficiency scores. Tobit equations were estimated for the entire sample and for subsamples consisting of for-profit (FP) and not-for-profit (NFP) nursing homes. The autho...

journal_title：Medical care

authors： Rosko MD,Chilingerian JA,Zinn JS,Aaronson WE

更新日期：1995-10-01 00:00:00

abstract：:This article describes the statistical methods and strategies to be used in establishing the linkages between processes and structures of care with risk-adjusted outcomes in a large multicenter Veterans Affairs cooperative study in health services of patients undergoing cardiac surgery. The statistical analyses consis...

journal_title：Medical care

authors： Marshall G,Henderson WG,Moritz TE,Shroyer AL,Grover FL,Hammermeister KE

更新日期：1995-10-01 00:00:00

abstract：:Legal factors related to the malpractice liability insurance purchased by general dentists in the United States were investigated using a comprehensive multivariate model that assessed the contribution of legal provisions affecting the probability of a malpractice claim, the probability of a payment, and the average s...

journal_title：Medical care

authors： Milgrom P,Whitney C,Conrad D,Fiset L,O'Hara D

更新日期：1995-08-01 00:00:00

abstract：:To study associations between payer and provision of services for patients hospitalized for coronary atherosclerosis, the authors analyzed abstracts of 24,424 discharges from California acute care hospitals during 1989. Services examined included receipt of coronary artery bypass surgery, percutaneous transluminal cor...

journal_title：Medical care

authors： Kuykendall DH,Johnson ML,Geraci JM

更新日期：1995-07-01 00:00:00

abstract：:In response to health care reform, health care providers have begun to develop interorganizational networks. At present, however, relatively little is known about factors facilitating participation in networks. To this end, organizational characteristics and views were obtained from key informants from both "Lead" and...

journal_title：Medical care

authors： Guihan M,Manheim LM,Hughes SL

更新日期：1995-05-01 00:00:00

abstract：:The increased demand for health status measures in evaluating medical interventions has increased the importance of clarifying when to use generic versus disease-specific health status measures. The authors compared the performance of a well known generic health status measure, the Sickness Impact Profile (SIP), and a...

journal_title：Medical care

authors： Damiano AM,Steinberg EP,Cassard SD,Bass EB,Diener-West M,Legro MW,Tielsch J,Schein OD,Javitt J,Kolb M

更新日期：1995-04-01 00:00:00

abstract：:There has been controversy about whether confounding by indication for treatment--that is, owing to physicians' conscious efforts to base treatment decisions on patients' pretreatment prognoses--makes nonrandomized, observational comparisons of treatments invalid. Some now believe evidence from studies of practice var...

journal_title：Medical care

authors： Poses RM,Smith WR,McClish DK,Anthony M

更新日期：1995-04-01 00:00:00

abstract：:The acceptability of satisfaction as a quality indicator is qualified by several well known measurement problems. This study examines the variability in satisfaction evaluations related to different measurement methods and the effect of response biases on reported satisfaction. Satisfaction evaluations using seven dif...

journal_title：Medical care

authors： Ross CK,Steward CA,Sinacore JM

更新日期：1995-04-01 00:00:00

abstract：:Although much is known about who pays the annual aggregate nursing home bill, relatively little is known about payment-source patterns of individuals during their lifetimes. In this article, lifetime payment-source patterns are analyzed for elderly nursing home users, particularly the extent to which they spend down a...

journal_title：Medical care

authors： Spillman BC,Kemper P

更新日期：1995-03-01 00:00:00

abstract：:Hospital cost-containment programs should themselves be cost-effective, targeting high-cost physicians (which requires adjusting for case mix) and patients (which requires early identification). In this study, clinical data available within 24 hours of admission from an electronic medical record system were used to de...

journal_title：Medical care

authors： Tierney WM,Fitzgerald JF,Miller ME,James MK,McDonald CJ

更新日期：1995-01-01 00:00:00

abstract：:Cataract surgery is the most frequently performed surgical procedure on Medicare beneficiaries, with an annual cost to the Medicare program of more than $3.4 billion. In this study, the relationship between demographic, environmental, and provider-related factors, and the likelihood that cataract surgery will be perfo...

journal_title：Medical care

authors： Javitt JC,Kendix M,Tielsch JM,Steinwachs DM,Schein OD,Kolb MM,Steinberg EP

更新日期：1995-01-01 00:00:00

abstract：:The authors conducted two studies of routine medical visits, investigating the relation of physician gender, patient gender, and physician age to patient satisfaction, and the correlations between communication behaviors and satisfaction separately for different combinations of patient and physician gender. Study 1 wa...

journal_title：Medical care

authors： Hall JA,Irish JT,Roter DL,Ehrlich CM,Miller LH

更新日期：1994-12-01 00:00:00

abstract：:The authors tested the "uncertainty hypothesis," which holds that variations in rates of hospitalization or surgeries across small geographic areas reflect differences in physicians' decision making when confronting uncertainty. A small-areas variation analysis of suspected acute cardiac ischemia (ACI) admissions in n...

journal_title：Medical care

authors： Green LA,Becker MP

更新日期：1994-11-01 00:00:00

abstract：:The purpose of this study was to develop a "time-insensitive" predictive instrument (TIPI) for acute hospital mortality due to congestive heart failure. In Phase 1, based on prospectively collected data on 401 congestive heart failure patients among 5,773 study patients who presented to six New England hospitals over ...

journal_title：Medical care

authors： Selker HP,Griffith JL,D'Agostino RB

更新日期：1994-10-01 00:00:00

abstract：:Amniocentesis and chorionic villus sampling are tests for the prenatal diagnosis of cytogenetic abnormalities. We calculated the incremental costs per abnormal birth averted, and the incremental costs per quality-adjusted outcome, of amniocentesis and chorionic villus sampling performed for the indication of maternal ...

journal_title：Medical care

authors： Heckerling PS,Verp MS

更新日期：1994-08-01 00:00:00

abstract：:Between 1989 and 1992, the Agency for Health Care Policy and Research (AHCPR) awarded funding to 14 special projects known as Patient Outcomes Research Teams (PORTs). These large, complex projects form the centerpiece of the first generation of research under the Medical Treatment Effectiveness Program. In carrying ou...

journal_title：Medical care

authors： Maklan CW,Greene R,Cummings MA

更新日期：1994-07-01 00:00:00

abstract：:In-hospital cardiopulmonary resuscitation (CPR) is associated with substantial costs beyond those of the resuscitation itself. These costs are important to understand because health care resources are limited. To that end, a model of CPR is proposed, including an examination of the effect of several variables on the c...

journal_title：Medical care

authors： Ebell MH,Kruse JA

更新日期：1994-06-01 00:00:00

abstract：:This paper investigates the difficulties that people encounter in their attempt to obtain needed health services, other than their third-party coverage or lack of it. These problems can be temporal, geographic, attitudinal, or financial (even with insurance). A state-wide sample survey conducted in 1989 revealed that ...

journal_title：Medical care

authors： Bashshur RL,Homan RK,Smith DG

更新日期：1994-05-01 00:00:00