Health Services Research articles from April 2000

Health Services Research archives from April 2000

The Agency for Healthcare Research and Quality: New Challenges, New Opportunities.
April 1, 2000... On December 19, 1999, the Agency for Health Care Policy and Research (AHCPR) was scheduled to celebrate an important milestone: the Agency's tenth anniversary. On that day in 1989, President Bush signed a law creating AHCPR "for the purpose of...

Slowly Remaking the U.S. Healthcare System.
April 1, 2000... For the past several years, Paul Ginsburg and colleagues, with support from the Robert Wood Johnson Foundation, have been tracking changes occurring in our nation's healthcare system. In this issue of Health Services Research, they report on...

Monitoring Market Change: Findings from the Community Tracking Study.
April 1, 2000... The Community Tracking Study Analyses of Market Change: Introduction Objective. To introduce two articles and describe methods that are common to them. Data Sources/Study Setting. Interviews conducted in person in 1996/1997 with...

Health Plan Competition in Local Markets.
April 1, 2000... Objective. To examine the structure of local health insurance markets and the strategies health plans were using to respond to competitive pressures in local markets in 1996/1997. Data Sources/Study Setting. Community Tracking Study site...

Organizing and Managing Care in a Changing Health System.
April 1, 2000... Objective. To examine ways in which the management and organization of medical care is changing in response to the shifting incentives created by managed care. Data Sources. Site visits conducted in 12 randomly selected communities in...

Issues in Employee Coverage and Use.
April 1, 2000... Simulating the Impact of Medical Savings Accounts on Small Business Objective. To simulate whether allowing small businesses to offer employer-funded medical savings accounts (MSAs) would change the amount or type of insurance coverage. ...

The Effect of Employee Assistance Programs Use on Healthcare Utilization.
April 1, 2000... Objective. To estimate the effect of Employee Assistance Program (EAP) use on healthcare utilization as measured by health claims. Data Sources. A unique data set that combines individual-level information on EAP utilization, demographic...

Impact of HMO Market Structure on Physician-Hospital Strategic Alliances.
April 1, 2000... Objective. To assess the impact of HMO market structure on the formation of physician-hospital strategic alliances from 1993 through 1995. The two trends, managed care and physician-hospital integration have been prominent in reshaping...

Outcomes Monitoring and the Testing of New Psychiatric Treatments: Work Therapy in the Treatment of Chronic Post-Traumatic Stress Disorder.
April 1, 2000... Objective. To evaluate the effectiveness of a work therapy intervention, the Department of Veterans Affairs (VA) Compensated Work Therapy program (CWT), in the treatment of patients suffering from chronic war-related post-traumatic stress...

Illicit Drug Use and Emergency Room Utilization.
April 1, 2000... Objective. To provide an empirical examination of the effect that chronic illicit drug use has on emergency room (ER) utilization, controlling for the potential biases introduced by correlation between unobservable determinants of chronic...

Editorial.
April 1, 2000... We are pleased to publish 12 of the 29 papers submitted this year for the Special Proceedings issue in honor of Alice Hersh. Eight of the articles address the role of insurance in promoting access to care, and the remaining four deal with...

1999 AHSR Presidential Address.
April 1, 2000... Better Health Care Decisions: Fulfilling the Promise of Health Services Research Two years ago, Bill Roper challenged us with an agenda of ten major research issues for the new health care environment created by the growth of for-profit...

Role of Insurance in Promoting Access to Care.
April 1, 2000... Uninsured and Unstably Insured: The Importance of Continuous Insurance Coverage Objective. To examine the importance of continuous health insurance for access to care by comparing the access and cost experiences of insured adults with a...

Promises Unfulfilled: Implementation of Expanded Coverage for the Elderly Poor.
April 1, 2000... Objective. To examine implementation of the Qualified Medicare Beneficiary (QMB) and Specified Low-Income Medicare Beneficiary (SLMB) programs, enacted in 1988. The article summarizes the origin of the QMB and SLMB programs, describes what we...

Does Type of Health Insurance Affect Health Care Use and Assessments of Care Among the Privately Insured?
April 1, 2000... Objective. To inform the debate about managed care by examining how different types of private insurance--indemnity insurance, PPOs, open model HMOs, and closed model HMOs--affect the use of health services and consumer assessments of care. ...

The Effect of Marginal Tax Rate on the Probability of Employment-based Insurance by Risk Group.
April 1, 2000... Research Objective. To evaluate the effect of the tax subsidy on participation in employment-based health insurance for high- and low-risk individuals. The total exclusion of employer-paid health insurance premiums from taxable income has...

Health Insurance May Be Improving--But Not for Individuals with Mental Illness.
April 1, 2000... Objective. To explore the question of how insurance coverage has changed among individuals with mental problems compared to the general population in the last two years. Data Sources. HealthCare for Communities, a national survey to track...

Mental Health Parity Legislation: Much Ado About Nothing?
April 1, 2000... Objective. To determine whether state-level parity legislation has led to an increase in utilization of mental health services. Data Sources. Healthcare For Communities (HCC), a multi-site nationally representative study sponsored by the...

Utilization of Specialty Mental Health Care Among Persons with Severe Mental Illness: The Roles of Demographics, Need, Insurance, and Risk.
April 1, 2000... Objective. To examine the sociodemographic, need, risk, and insurance characteristics of persons with severe mental illness and the importance of these characteristics for predicting specialty mental health utilization among this group. ...

Community Effects on Access to Behavioral Health Care.
April 1, 2000... Objectives. To explore the effects of community-level factors on access to any behavioral health care and specialty behavioral health care. Data. Healthcare for Communities household survey data, merged to supplemental data from the 1990...

Quality, Outcomes, and Satisfaction.
April 1, 2000... Individual Income, Income Inequality, Health, and Mortality: What Are the Relationships? Objective. To examine the pathways between income inequality, self-rated health, and mortality in the United States. Data Source. The first...

Do Quality Report Cards Play a Role in HMOs' Contracting Practices? Evidence from New York State.
April 1, 2000... Objective. To answer two related questions: (1) Do managed care organizations (MCOs) in New York State (NYS) consider quality when they choose cardiac surgeons? (2) Do they use information about risk-adjusted mortality rates (RAMR) provided in...

Associations Between Primary Care Physician Satisfaction and Self-reported Aspects of Utilization Management.
April 1, 2000... Objective. To evaluate the association between physician-reported utilization management (UM) techniques in capitated physician groups and physician satisfaction with capitated care. Study Setting. 1,138 primary care physicians from 89...

Comparing Consumer-directed and Agency Models for Providing Supportive Services at Home.
April 1, 2000... Objective. To examine the service experiences and outcomes of low-income Medicaid beneficiaries with disabilities under two different models for organizing home-based personal assistance services: agency-directed and consumer-directed. ...