解剖学和形态学
麻醉学
听力与言语-语言病理学
行为科学
心脏和心血管系统
细胞和组织工程学
临床神经病学
危重症监护医学
牙科,口腔外科和医学
皮肤病学
急诊医学
内分泌学和新陈代谢
肠胃学和肝脏学
老人病学和老年医学
卫生保健科学和服务
血液学
免疫学
传染病
综合和补充性医学
医学伦理学
医学信息学
医学实验室技术
医学,全科和内科
医学,法律
医学,研究和试验
神经系统科学
护理
营养学和饮食学
产科医学和妇科医学
肿瘤学
眼科学
整形外科学
耳鼻喉科学
病理学
儿科学
周围血管疾病
药理学和药剂学
生理学
基本医疗保健
精神病学
公共、环境和职业卫生
放射学,核医学和医学成像
康复学
生殖生物学
呼吸系统
风湿病学
运动科学
外科学
毒理学
热带医学
泌尿学和肾脏学
病毒学
老年医学
健康政策和服务
心理学,临床
abstract:BACKGROUND:Primary care teams face daily time pressures both during patient encounters and outside of appointments. OBJECTIVES:We theorize 2 types of time pressure, and test hypotheses about organizational determinants and patient consequences of time pressure. RESEARCH DESIGN:Cross-sectional, observational analysis ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000974
更新日期:2018-10-01 00:00:00
abstract:INTRODUCTION/OBJECTIVES:The engagement of patients and other stakeholders is a critical element in the design of patient-centered outcomes research studies. However, methodology for scalable engagement in research management particularly activities such as operationalization of principles and setting of priorities is n...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000790
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Although the life expectancy for the US population has increased, a high proportion of this population has lived with ≥1 chronic conditions. We have quantified the burden of disease associated with 15 chronic conditions and combinations of conditions by estimating quality-adjusted life years (QALYs) for olde...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000943
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Nearly half of US births are financed by Medicaid, and one-third of births occur by cesarean delivery, at double the cost of vaginal delivery. With the goal of reducing unnecessary cesarean use and improving value, in 2009 Minnesota's Medicaid program introduced a blended payment rate for uncomplicated birth...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000937
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:The Veterans Choice Program (VCP) was launched in 2014 to address the growing concerns about the timeliness and quality of Veterans Health Administration (VHA) care. Given that many sex-specific health services, such as mammography and maternity care, are not routinely provided in all VHA facilities, women V...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000933
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Early magnetic resonance imaging (MRI) for acute low back pain (LBP) has been associated with increased costs, greater health care utilization, and longer disability duration in workers' compensation claimants. OBJECTIVES:To assess the impact of a state policy implemented in June 2010 that required prospect...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000917
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Emergency Department (ED) boarding threatens patient safety. It is unclear whether boarding differentially affects patients admitted to intensive care units (ICUs) versus non-ICU settings. RESEARCH DESIGN AND SUBJECTS:We performed a 2-hospital, 18-month, cross-sectional, observational, descriptive study of ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000902
更新日期:2018-05-01 00:00:00
abstract::Sequential analysis can be used as an early warning system about potential unintended consequences of health policy decisions, generating follow-up investigations, but it should not be used as causal evidence. ...
journal_title:Medical care
pub_type: 评论,杂志文章
doi:10.1097/MLR.0000000000000896
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Adherence to medication treatment plans is important for chronic disease (CD) management. Cost-related nonadherence (CRN) puts patients at risk for complications. Native Hawaiians and Pacific Islanders (NHPI) suffer from high rates of CD and socioeconomic disparities that could increase CRN behaviors. OBJEC...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000887
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Without advanced preparation of legal documents, state law determines who may serve as a surrogate decision maker for patients in hospitals. OBJECTIVES:To examine the relationship characteristics associated with traditional versus nontraditional health care surrogates who are making medical decisions for pa...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000890
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:The 2016 President's Cancer Panel Connected Health report calls for thoroughly characterizing the team structures and processes involved in coordinating care for people with chronic conditions. We developed a multilevel care coordination framework by integrating existing frameworks from the teams and care co...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/MLR.0000000000000874
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:Patients with multiple chronic conditions (MCCs) are a critical but undefined group for quality measurement. We present a generally applicable systematic approach to defining an MCC cohort of Medicare fee-for-service beneficiaries that we developed for a national quality measure, risk-standardized ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000853
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Difference-in-differences (DID) estimation has become increasingly popular as an approach to evaluate the effect of a group-level policy on individual-level outcomes. Several statistical methodologies have been proposed to correct for the within-group correlation of model errors resulting from the clustering...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/MLR.0000000000000830
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:The intensive and varied services required by high-need patients have inspired a number of new care delivery models; however, evidence of their effectiveness is mixed. This study evaluated whether augmenting a patient-centered medical home (PCMH) with intensive outpatient management enhances high-need patient...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000833
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVES:Studies of cancer recurrences and second primary tumors require information on outcome dates. Little is known about how well electronic health record-based algorithms can identify dates or how errors in dates can bias analyses. RESEARCH DESIGN:We assessed rule-based and model-fitting approaches to assign ev...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000352
更新日期:2017-12-01 00:00:00
abstract::Disparities by economic status are observed in the health status and health outcomes of Medicare beneficiaries. For health services and health policy researchers, one barrier to addressing these disparities is the ability to use Medicare data to ascertain information about an individual's income level or poverty, beca...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000606
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Trend analyses of opioid-related inpatient stays depend on the availability of comparable data over time. In October 2015, the US transitioned diagnosis coding from International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to ICD-10-CM, increasing from ∼14,000 to 68,000 codes...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000805
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Acute health care utilization often occurs among persons experiencing homelessness. However, knowing which individuals will be persistent super-utilizers of acute care is less well understood. OBJECTIVE:The objective of the study was to identify those more likely to be persistent super-utilizers of acute ca...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000796
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:There has been considerable debate in recent years about whether, and how, to risk-adjust quality measures for sociodemographic characteristics. However, geographic location, especially rurality, has been largely absent from the discussion. OBJECTIVE:To examine differences by rurality in quality outcomes, a...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000761
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Social determinants of health (SDH) data collected in health care settings could have important applications for clinical decision-making, population health strategies, and the design of performance-based incentives and penalties. One source for cataloging SDH data is the International Statistical Classifica...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000764
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:The Veterans Health Administration does not routinely collect and document sexual orientation and gender identity (SOGI) data, despite existing health disparities among sexual and gender minority Veterans. Because of the legacy of previous Department of Defense (DoD) policies that prohibited disclosure of se...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000744
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:There is an increasing demand for electronic health record (EHR)-based risk stratification and predictive modeling tools at the population level. This trend is partly due to increased value-based payment policies and the increasing availability of EHRs at the provider level. Risk stratification models, howev...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000754
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Fried and colleagues described a frailty phenotype measured in the Cardiovascular Health Study (CHS). This phenotype is manifest when ≥3 of the following are present: low grip strength, low energy, slowed waking speed, low physical activity, or unintentional weight loss. We sought to approximate frailty phen...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000729
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Administrative database research can provide insight into the real-world effectiveness of invasive electrophysiology procedures. However, no validated algorithm to identify these procedures within administrative data currently exists. OBJECTIVE:To develop and validate algorithms to identify atrial fibrillat...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000274
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Estimating population-level obesity rates is important for informing policy and targeting treatment. The current gold standard for obesity measurement in the United States-the National Health and Nutrition Examination Survey (NHANES)-samples <0.1% of the population and does not target state-level or health s...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000693
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:A number of health care initiatives seek to improve health outcomes by increasing access to outpatient services while reducing preventable acute events. We evaluated disparities between American Indian and Alaska Native (AI/AN) and non-Hispanic white (white) Medicare enrollees in access to outpatient preventi...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000698
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Medicare's Nonpayment Program of 2008 (hereafter called Program) withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs). Little is known whether a hospital's Medicare patient load [quantified by the hospital's Medicare utilization ratio (MUR), which is the proportion of inp...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000680
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Safety-net and teaching hospitals are somewhat more likely to be penalized for excess readmissions, but the association of other hospital characteristics with readmission rates is uncertain and may have relevance for hospital-centered interventions. OBJECTIVE:To examine the independent association of 8 hosp...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000713
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Continuity of nursing care in hospitals remains poor and not prioritized, and we do not know whether discontinuous nursing care is negatively impacting patient outcomes. OBJECTIVES:This study aims to examine nursing care discontinuity and its effect on patient clinical condition over the course of acute hos...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000670
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Although the Affordable Care Act has been successful in expanding Medicaid to >17 million people, insurance alone may not translate into access to health care. Even among the insured, substantial barriers to accessing services inhibit health care utilization. OBJECTIVES:We examined the effect of selected ba...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000644
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Young men who have sex with men (YMSM) have the highest rates of human immunodeficiency virus (HIV) infection in the United States. Decades into the HIV epidemic, the relationships that YMSM-serving health and social organizations have with one another has not been studied in depth. OBJECTIVES:The aim of th...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000595
更新日期:2017-02-01 00:00:00
abstract:STUDY OBJECTIVES:To assess the feasibility of using the SF-36v2 mental health (MH) and mental component summary (MCS) scores for classification of risk for major depressive disorder (MDD), and to determine cut-off scores based on the sensitivity and specificity in a general US representative sample, and a chronic pain ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000617
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Hospital administrative health data create separate records for each hospital stay of patients. Treating a hospital transfer as a readmission could lead to biased results in health service research. METHODS:This is a cross-sectional study. We used the hospital discharge abstract database in 2013 from Albert...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000624
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:In 2002 British Columbia, Canada began redistributing its hospital services. OBJECTIVE AND DESIGN:We used administrative data and interrupted time series analyses to determine how recent hospital closures affected patient outcomes. SUBJECTS:All adult acute myocardial infarction (AMI), stroke, and trauma ev...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000619
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:With rising health spending, predicting costs is essential to identify patients for interventions. Many of the existing approaches have moderate predictive ability, which may result, in part, from not considering potentially meaningful changes in spending over time. Group-based trajectory modeling could be u...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000623
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:A need exists for adapting existing perioperative risk stratification methods such as the Charlson Comorbidity Index (CCI) for application with hospital administrative data in noncardiac surgery populations. OBJECTIVE:Develop and validate outcome-specific CCIs for predicting inpatient mortality, and cardiac...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000592
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:In 1998, the Province of Ontario in Canada adopted price-cap "70/90" regulations whereby the first generic entrant was required to be priced at ≤70% of the associated brand-name product and subsequent generics were priced at ≤90% of the first generic price. The price-caps were further lowered to 50% in 2006 ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000577
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:The transition from Medicaid-only to dual Medicare/Medicaid coverage has the potential to reduce financial barriers to health care for patients with serious mental illness through increased coverage or expanded access to clinicians as their reimbursement increases. AIMS:To estimate the effect of dual covera...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000572
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:The Affordable Care Act allowed an optional Medicaid State Plan benefit for states to establish Health Homes coordinating care for people who have chronic conditions. Differences in medical home program incentives and implementation styles are important to understand in evaluating effects on key outcomes suc...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000555
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Readmission and length of stay (LOS) are increasingly accepted as quality measures for surgical care. Centers for Medicare & Medicaid Services will soon assess penalties for excessive readmissions after coronary artery bypass graft (CABG) surgery and hip and knee replacements. OBJECTIVE:To determine and com...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000528
更新日期:2016-06-01 00:00:00