Health Services Research articles from December 2003

Health Services Research archives from December 2003

Measuring quality in modern managed care.(Editorial)
December 1, 2003... The collection of health plans commonly referred to as "managed care" has come to include an astonishing variety of forms. Although a few are tightly integrated prepaid group practices, a much larger number reflect the complex mixes of...

Special issues, special sections--special consideration?
December 1, 2003... This December issue of Health Services Research (HSR) has a special section called "Managing Chronic Illness in Managed Care Settings." Packaged with the regular issue is a special issue on "Social Determinants." This provides a good...

Was breast conserving surgery underutilized for early stage breast cancer? Instrumental variables evidence for stage II patients from Iowa.
December 1, 2003... The initial treatment decision for patients with early stage breast cancer (stages I, IIa, and IIb) is the surgical approach for local tumor control--mastectomy (MAS) or breast conserving surgery plus irradiation (BCSI). In its 1991 Consensus...

Competition, payers, and hospital quality (1).
December 1, 2003... Two types of insurers dominate the U.S. health care economy: the federal and state governments, through the Medicare and Medicaid programs, and privately purchased managed care or health maintenance organizations (HMOs). These insurance systems...

Does aggressive care following acute myocardial infarction reduce mortality? Analysis with instrumental variables to compare effectiveness in Canadian and United States patient Populations.
December 1, 2003... Most regions of the United States tend to adopt an aggressive approach to care for acute myocardial infarction (AMI)--using invasive procedures such as cardiac catheterization in all patients and revascularization in most patients-while most...

Mental health services use among school-aged children with disabilities: the role of sociodemographics, functional limitations, family burdens, and care coordination.
December 1, 2003... Children with disabilities or chronic illnesses have been shown to be at increased risk for psychological morbidity (Bennett 1994; Bussing et al. 1995; Drotar 1997; Lavigne and Faier-Routman 1992; Noll et al. 1999; Pless, Roghmann, and Haggerty...

The impact of the prospective payment system for skilled nursing facilities on therapy service provision: a transaction cost approach.
December 1, 2003... In a typical skilled nursing facility (SNF), numerous parties exchange goods and services in the delivery of care. Resident care is rendered through a complex series of transactions among these parties, including, but not limited to:...

Measuring hospital quality: can Medicare data substitute for all-payer data?
December 1, 2003... Monitoring quality of care across institutions and over time and examining the correlates of quality are critical to pursuing effective policy to improve quality (Institute of Medicine Committee on Quality of Health Care in America 2001; Kohn...

Psychometric properties of the consumer assessment of health plans study (CAHPS[R]) 2.0 adult core survey.
December 1, 2003... Systematic collection of consumer feedback is now common in health care. Health plans and providers use survey data for quality assessment and improvement; purchasers use consumer surveys for selecting health plans; and, consumers and patients...

Measuring the quality of diabetes care using administrative data: is there bias?(Managing Chronic Illness in Managed Care Settings)
December 1, 2003... In recent years, efforts to measure and improve the quality of care have expanded to include care for chronic medical conditions, such as diabetes mellitus, that are primarily treated in outpatient settings. In addition to providing information...

How robust are health plan quality indicators to data loss? a Monte Carlo simulation study of pediatric asthma treatment.(Managing Chronic Illness in Managed Care Settings)
December 1, 2003... Quality Indicators (QIs) have become benchmarks for evaluating health plan performance. Typically, QIs are based on evidence-driven measures of quality of care for plan populations as a whole (e.g., percentage of members receiving an annual flu...

Variability in asthma care and services for low-income populations among practice sites in managed Medicaid systems.(Managing Chronic Illness in Managed Care Settings)
December 1, 2003... Medicaid managed care (MMC) has the potential to ensure quality of care for poor children by increasing access to care (Gadomski, Jenkins, and Nichols 1998). However, the rapid infusion of large numbers of Medicaid-enrolled children into varied...

Methodological challenges associated with patient responses to follow-up longitudinal surveys regarding quality of care.(Managing Chronic Illness in Managed Care Settings)
December 1, 2003... In recent years, longitudinal data analysis has been heralded as a means to allow us to learn about the relationships between what is done for a patient (process of care) and what happens to them (outcomes of care) (Donabedian 1988, 1968;...

Managed care organizational characteristics and health care use among children with special health care needs.(Managing Chronic Illness in Managed Care Settings)
December 1, 2003... With rising health care costs, state programs, such as Medicaid and the State Children's Health Insurance Program (SCHIP), have turned to managed care as a way to improve access to care, while controlling health care expenditures for children...

Sampling patients within physician practices and health plans: multistage cluster samples in health services research.(Managing Chronic Illness in Managed Care Settings)
December 1, 2003... Most surveys or data collection efforts in health services research have multiple goals. Frequently several researchers or institutions will jointly conduct a study, each with a different primary analytical interest. Even within a single...

Guest editors' introduction: in pursuit of the social determinants of health: the evolution of health services research.(Editorial)
December 1, 2003... Health services research typically concerns itself with issues of organization, financing, utilization, and costs of health care. Improving access to and the delivery of high-quality, efficient care, it is hoped, will improve the health of the...

Measuring contextual characteristics for community health.(Measurement Issues in Social Determinants)
December 1, 2003... Much has been accomplished to improve health and reduce disparities through understanding and intervening on individual-level risk factors for major causes of morbidity and mortality (U.S. Preventive Services Task Force 1996; Ketola, Sipila,...

Racial segregation and longevity among African Americans: an individual-level analysis.(Measurement Issues in Social Determinants)
December 1, 2003... The twentieth century witnessed tremendous expansion of the upper bounds of human life. At the beginning of the century, average life expectancy in the United States was 47 years old. By century's end, life expectancy had risen to excess of 70...

The association between multiple domains of discrimination and self-assessed health: a multilevel analysis of Latinos and blacks in four low-income New York city neighborhoods.(Measurement Issues in Social Determinants)
December 1, 2003... Disparities between the health of blacks, Latinos, and whites have been documented across a wide variety of health indicators. Black men and women have lower life expectancy than whites (Anderson et al. 1997; Geronimus et al. 1996; Williams...

Distributional issues in the analysis of preventable hospitalizations.(Measurement Issues in Social Determinants)
December 1, 2003... A key component of health care access is the receipt of timely and effective primary care to manage chronic illness and to treat acute illness at an early stage before hospitalization becomes necessary. Extensive literature documents...

On the importance of age-adjustment methods in ecological studies of social determinants of mortality.
December 1, 2003... Numerous ecological studies report that mortality in the United States is significantly associated with area-level socioeconomic factors, including income inequality (e.g., Kaplan et al. 1996; Kennedy et al. 1996; Kawachi and Kennedy 1997b;...

Nonlinearity in demographic and behavioral determinants of morbidity.
December 1, 2003... Socioeconomic status (SES) indicators, including income and education, are consistently related to increased mortality and mental and physical morbidity, as well as to biological risk factors and health-related behaviors (Liberatos, Link, and...

Socioeconomic gradients and low birth-weight: empirical and policy considerations.(empirical analyses)
December 1, 2003... Disparities have been a puzzling fact of life for the health of populations in most developed countries whose death rates are driven by chronic, rather than infectious disease. In the United States, health disparities by race/ethnic group and...

Social determinants of tooth loss.(empirical analyses)
December 1, 2003... The growing literature on racial, ethnic, and socioeconomic status (SES) disparities in health has documented significantly poorer health among low-SES and non-Hispanic African Americans (AAs) when compared to high-SES persons and non-Hispanic...

County-level income inequality and depression among older Americans.(empirical analyses)
December 1, 2003... Researchers have consistently demonstrated a strong association between socioeconomic status (SES) and health at the individual level (Robert 1998; Smith 1998). What is new is an increasing interest in how socioeconomic conditions of the area...

Racial differences in the receipt of bowel surveillance following potentially curative colorectal cancer surgery.(empirical analyses)
December 1, 2003... Colorectal cancer is the second leading cause of cancer mortality in the United States and is estimated to account for 56,600 deaths in 2002 (Jemal et al. 2002). Important racial and ethnic differences exist in colorectal cancer incidence and...

Tackling health inequalities in the United Kingdom: the progress and pitfalls of policy.(policy implications)
December 1, 2003... This article is based on the premise that many of the causes and manifestations of health inequalities in the United Kingdom and the United States have been described and are largely understood (Marmot and Wilkinson 1999, Berkman and Kawachi...

What new knowledge would help policymakers better balance investments for optimal health outcomes?(policy implications)
December 1, 2003... "How much, then, should go for medical care, and how much for other programs affecting health such as pollution control, fluoridation of water, accident prevention, and the like? There is no simple answer, partly because the question has rarely...