Health Services Research articles from August 2004

Health Services Research archives from August 2004

Quality of health care: the views of homeless youth.(Quality and Quality Improvement)
August 1, 2004... Homeless youth are a medically underserved and vulnerable population in the United States. Based on recent research using a nationally representative sample of U.S. households, homelessness in adolescents ages 12-17 is more common than for...

Quality of care for patients with type 2 diabetes mellitus in the Netherlands and the United States: a comparison of two quality improvement programs.(Quality and Quality Improvement)
August 1, 2004... In the last decades, care for patients with type 2 diabetes has shifted away from hospitals and toward general practice (Griffin and Kinmonth 1997; Wood 1990). Numerous general practice guidelines for diabetes care have been published. However,...

Patient satisfaction, treatment experience, and disability outcomes in a population-based cohort of injured workers in Washington State: implications for quality improvement.(Quality and Quality Improvement)
August 1, 2004... In recent years, increased emphasis has been placed upon improving the quality of health care in the United States in response to evidence indicating that quality for too many patients is not what it should or could be (Schuster, McGlynn, and...

Multihospital system membership and patient treatments, expenditures, and outcomes.(Organizational Issues)
August 1, 2004... In recent years the proportion of hospitals affiliated with other hospitals has grown. In 1985, for example, 38 percent of nonpublic general medical-surgical hospitals responding to the American Hospital Association (AHA) Annual Survey...

Competing values of emergency department performance: balancing multiple stakeholder perspectives.(Organizational Issues)
August 1, 2004... The ability of emergency departments (ED) to respond to patient care needs is an important public policy issue. In the current environment of health system restructuring and renewal, EDs are challenged to be flexible and to adapt to changing...

The relationship of Medicaid payment rates, bed constraint policies, and risk-adjusted pressure ulcers.(Health Insurance)
August 1, 2004... Substandard nursing home quality has been a persistent policy issue over the past three decades (e.g., U.S. Senate 1974; U.S. General Accounting Office 1987; Institute of Medicine 2001). The relationship between poor quality and Medicaid...

Trust in insurers and access to physicians: associated enrollee behaviors and changes over time.(Health Insurance)
August 1, 2004... Many concerns exist about the extent to which managed care structures and techniques affect patients' trust in physicians and health insurers (Anders 1996; Mechanic and Schlesinger 1996). To explore these concerns, there has been burgeoning...

The impact of medicaid managed care on pregnant women in Ohio: a cohort analysis.(Health Insurance)
August 1, 2004... Two converging trends in the 1980s and 1990s--the Medicaid expansions for pregnant women and the rapid expansion in the use of managed care approaches in Medicaid--have led to a greatly expanded role for managed care in the pregnancies of low...

The effect of benefits, premiums, and health risk on health plan choice in the Medicare program.(Health Insurance)
August 1, 2004... Under the current structure of the Medicare program, payments to Medicare+Choice (M+C) managed care plans are determined by a complex administrative formula that takes data on historical Medicare fee-for-service (FFS) costs and inflates it at...

Context or composition: what explains variation in SCHIP disenrollment?(Health Insurance: State Children's Health Insurance Program)
August 1, 2004... Many studies show that medically uninsured children are less likely to have a regular source of care or to have coordinated, comprehensive preventive health services (Eisert and Gabow 2002; McCormick et al. 2000; Newacheck et al. 1998; Szilagyi...

Variations in nurse practitioner use in veterans affairs primary care practices.(Practice Patterns)
August 1, 2004... Health care organizations face ongoing pressures to deliver high-quality care, ensure access to care, and contain costs. Increasingly, primary care practices include nurse practitioners (NPs) in their staffing mix in order to meet these demands...

Influenza and pneumococcal vaccination demand responses to changes in infectious disease mortality.(Practice Patterns)
August 1, 2004... Pneumonia and influenza are infectious diseases with severe health consequences for the general population, and for the elderly in particular. Based on recent reports from the Centers for Disease Control and Prevention (CDC), pneumonia and...

Adoption of liquid-based cervical cancer screening tests by family physicians and gynecologists.(Practice Patterns)
August 1, 2004... The FDA approved the ThinPrep[R] Pap Test[TM], a liquid-based cervical cancer screening test, in 1996 (Johannes 1998) (Cytyc Corporation 2001). Ever since, the ThinPrep Pap test has been rapidly replacing the conventional Pap smear, even though...

Antiretroviral therapy and health care utilization: a study of privately insured men and women with HIV disease.(Practice Patterns)
August 1, 2004... Ensuring access to expensive new drug therapies for persons with HIV disease is important because access to these therapies is related to morbidity and mortality (Palella et al. 1998). Over the past decade, the proportion of costs attributable...

Hospice use by Hispanic and non-Hispanic white cancer decedents.(Practice Patterns)
August 1, 2004... Hospice services are typically used when aggressive therapy is no longer being sought and death is expected to occur within six months. The number of patients opting for this type of care is increasing. In the last decade, for example, the use...

Economic profiling of primary care physicians: consistency among risk-adjusted measures.(Methods)
August 1, 2004... Managed care plans in the United States are increasingly using paid claims records to monitor and judge the physicians who provide services to plan members. The motivation for economic, or "practice efficiency," profiling, as this is termed, is...

Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers.(Methods)
August 1, 2004... Two significant emerging policy directions put patients and consumers in a key role for influencing health care quality and costs. First, consumer-directed health plans rely on informed consumer choices to contain costs and improve the quality...

Coding response to a case-mix measurement system based on multiple diagnoses.(Methods)
August 1, 2004... Case-mix based reimbursement of hospitals is internationally pervasive, with the most common (1) patient classification systems in use being those related to diagnostic related groups (DRG). Since the introduction of the Prospective Payment...

Correction to cover of HSR 39:3 June issue.(Erratum)(Correction Notice)
August 1, 2004... On the cover of Health Services Research 39 (3) the article tide and authors listed below should have appeared as follows: R. Tamara Konetzka, Deokhee Yi, Edward C. Norton, et al. Effects of Medicare Payment Changes on Nursing Home...

Consumer-driven health care--beyond rhetoric with research and experience.(Guest Editors' Introduction)
August 1, 2004... The search for ways to stem the rising tide of health insurance premiums and improve the value of care being purchased has entered a new era. Bolstered by the explosion of information technology and prompted by the managed care backlash,...

Awakening consumer stewardship of health benefits: prevalence and differentiation of new health plan models.
August 1, 2004... Accelerating growth in health insurance premiums coupled with an economic downturn have generated a renewed focus on cost control in the U.S. health benefits sector. The prevailing vision for cost control in the current employer-sponsored...

Tales from the new frontier: pioneers' experiences with consumer-driven health care.(Consumer-driven plans: what's offered? Who chooses?)
August 1, 2004... Consumer-driven health care (CDHC) has been touted as the salvation of our health care system (Herzlinger forthcoming)--or as the hastening of its demise (Shuit 2003). Proponents point to facets that promote greater choice among health plans...

Employee choice of Consumer-Driven Health insurance in a multiplan, multiproduct setting.(Consumer-driven plans: what's offered? Who chooses?)
August 1, 2004... "Consumer-driven" health plans (CDHPs) have moved beyond the concept stage and are now available to employees of many large companies. Established insurers, such as Aetna, Humana, Cigna, UnitedHealth Group, and WellPoint are introducing their...

Commentary--how consumer-driven health care evolves in a dynamic market.(Consumer-driven plans: what's offered? Who chooses?)
August 1, 2004... This volume presents an enormous amount of information that will take students of consumer-driven health care a very long time to read and digest. It will be tempting for both advocates and opponents of the movement for greater consumer control...

Commentary--current MSA theory: well-meaning but futile.(Medical savings accounts)
August 1, 2004... Medical savings accounts (MSAs), in their current form, generally represent an increasingly visible and well-meaning, but potentially futile and sometimes counterproductive, attempt to include consumers in the major costs of care in any...

Consumer experiences in a consumer-driven health plan.(Evidence about Consumer Experiences)
August 1, 2004... The label "consumer-driven health plan" (CDHP) has been used to describe a wide variety of different health benefit designs that shift more health care costs to consumers at the point of service, on the presumption that it is desirable to give...

Early experience with employee choice of consumer-directed health plans and satisfaction with enrollment.(Evidence about Consumer Experiences)
August 1, 2004... Employers feel increasing pressure to address rising health care costs. One option to help reduce employer costs is to shift from a defined health care benefit, in which the employer provides and subsidizes one or more health plans, to a...

Commentary--defined contribution health plans: attracting the healthy and well-off.(Evidence about Consumer Experiences)
August 1, 2004... Driven by a philosophy that favors unbridled faith in the free marketplace, the year 2003 may well go down in health care history as the year that the health care system officially abandoned the premise that the community has a responsibility...

Risk segmentation related to the offering of a consumer-directed health plan: a case study of Humana Inc.(Evidence about Utilization and Expenditures)
August 1, 2004... In this article we examine what happened when one employer expanded its employee health benefit offerings to include a "consumer-directed" option--a benefit design that gives enrollees some first-dollar coverage but asks them to accept greater...

Evaluation of the effect of a consumer-driven health plan on medical care expenditures and utilization.(Evidence about Utilization and Expenditures)
August 1, 2004... Consumer-driven health plans (CDHPs) have moved beyond the concept stage and are now health benefit options available to employees in many large companies. Mainstream insurers, such as Aetna, United Health Group, and Wellpoint have introduced...

Commentary--looking at the effects of consumer-centric health plans on expenditures and utilization.(Evidence about Utilization and Expenditures)
August 1, 2004... Consumer-centric health plans are now emerging as one of the possible solutions to the inappropriate use of health services and the high cost of health insurance in the United States. Labeled variously as "consumer-directed health plans,"...

Consumer-directed health care: will it improve health system performance?(financial incentives to patients, utilization of health services)
August 1, 2004... The excellent set of papers contained in this issue provides important insight into early experience with consumer-directed health care plans. While more experience and research are required to reach definitive conclusions, the evidence to date...