Health Services Research articles from February 2003

Health Services Research archives from February 2003

Managed care, access to specialists, and outcomes among primary care patients with pain. (Quality and Outcomes of Care).
February 1, 2003... As managed care has grown over the past decade, so have concerns that managed care controls reduce access to specialists, which may result in adverse outcomes for patients (Kassirer 1994). Few studies have examined this question among primary...

Impact of cardiac service availability on case-selection for angiography and survival associated with angiography.
February 1, 2003... Several studies have found that availability of angiograhy or revascularization facilities at the admitting hospital substantially increases the likelihood of a patient receiving angiography following an acute myocardial infarction (AMI) (Every...

Process of care and outcome after acute myocardial infarction for patients with mental illness in the VA health care system: are there disparities?
February 1, 2003... Disparities in health care use and outcome are receiving increasing attention. Of particular concern are findings of lower rates of health care utilization among certain vulnerable groups, such as minorities (Wenneker and Epstein 1989; Hannan...

Quality improvement implementation in the nursing home.
February 1, 2003... BACKGROUND AND HYPOTHESES The VA operates a federally financed health care system for eligible veterans. The system comprises more than 150 medical centers, many of which have associated nursing homes. Although part of a larger medical...

Utilization of home health services before and after the Balanced Budget Act of 1997: what were the initial effects? (Public Policy Impact).
February 1, 2003... The utilization of home health care services under Medicare has undergone dramatic decreases in the last four years, as Congress, the Centers for Medicare and Medicaid Services (CMS, formerly the Health Care Financing Administration), and other...

Medicare home health utilization in context. (Commentary).
February 1, 2003... HOME HEALTH IN HISTORICAL CONTEXT Medicare's home health benefit has gone through two major boom and bust cycles since 1980, largely because there is so much confusion and ambivalence about just what the benefit is supposed to do. Home care...

The effect of health plan characteristics on Medicare+Choice enrollment.
February 1, 2003... The current Medicare program features a government-administered fee-for-service (FFS) health plan and private health plans under contract to the federal government. The latter part of the program is referred to as "Medicare+Choice," or M+C, and...

Is exposure to income inequality a public health concern? Lagged effects of income inequality on individual and population health. (Other Articles).
February 1, 2003... There is a sharp division among health policy researchers regarding the extent to which income inequality is a public health problem: some advocate the health benefits of egalitarian social policies (e.g., Wilkinson 1996, and Daniels, Kennedy,...

Income inequality as a public health concern: where do we stand? Commentary on "is exposure to income inequality a public health concern?". (Commentary).
February 1, 2003... THE INCOME INEQUALITY/HEALTH LINK: A DISAPPEARING CONNECTION? Research interest on the link between income distribution and population health can be traced back to Richard Wilkinson's seminal paper published in 1992 in the British Medical...

Determinants of HMO formulary adoption decisions.
February 1, 2003... A drug formulary is a list of approved drugs. (1) The term is historically associated with hospitals; a hospital pharmacy stocks those drugs on the hospital formulary and some nonformulary items. (2) Today, formularies are an essential...

The effect of capitation on switching primary care physicians.
February 1, 2003... Capitation creates potential conflicts of interest between physicians' incomes and patients' expectations for treatment, especially among the chronically ill (Blumenthal 1994; Rodwin 1993). Physicians worry that capitation will cause them to...

Racial and ethnic disparities in the purchase of nongroup health insurance: the roles of community and family-level factors.
February 1, 2003... Many current proposals for increasing health insurance coverage of Americans rely on encouraging individuals and families to purchase their health insurance through the nongroup (also called the individual) market. These proposals often...

Effectiveness and cost-effectiveness of four treatment modalities for substance disorders: a propensity score analysis.
February 1, 2003... Alcohol and substance use are common and affect the lives of many Americans. Approximately 14 million Americans currently abuse illicit drugs and a similar number abuse alcohol (Substance Abuse Chartbook 2001; Grant et al. 1994). Estimating the...

Factors that influence line managers' perceptions of hospital performance data.
February 1, 2003... Performance measurement has emerged as an important public policy issue in health care. Data gathering on the performance of health systems, organizations, and individual care providers is being undertaken widely. These efforts measure clinical...

Primary care service areas: a new tool for the evaluation of primary care services. (Methods).
February 1, 2003... The need to improve the availability and effectiveness of primary care services in the United States was recognized as long ago as 1932 in the Final Report of the Committee on the Costs of Medical Care (1932), and remains a perennial concern of...

Catching up on health outcomes: the Texas medication algorithm project.
February 1, 2003... In this paper, we developed a new approach, called the Declining-Effects Model, to analyze longitudinal data evaluating a disease management program (DMP) for patients with chronic illness, including mental illness. This approach takes into...

Guest editors' introduction. (Editorial Column).
February 1, 2003... The organization and financing of health care has experienced a roller coaster of change over the past several years, with the rise and fall of managed care and reverberations felt throughout the health care system. In our work at the Center...

The end of an era: what became of the "managed care revolution" in 2001? (Community Tracking).
February 1, 2003... As health care inflation reached double-digit rates of annual increase in the early 1990s, many touted the promise of managed care to foster a more efficient and effective delivery system. While many private employers moved their employees into...

Managing costs, managing benefits: employer decisions in local health care markets.
February 1, 2003... Results from surveys of employer health benefit offerings are reported on a regular basis in the popular press and, occasionally, academic journals (for example see BNA's Health Care Policy Report 2001; Medical Benefits 200 la; Reese 2001a;...

An empty toolbox? Changes in health plans' approaches for managing costs and care.
February 1, 2003... The growth of managed care during past three decades has fostered the development of a variety of tools for containing health care costs and promoting coordination and efficiency in service delivery, and has fueled the diffusion of these tools...

Medicare contracting risk/medicare risk contracting: a life-cycle view from twelve markets.
February 1, 2003... Policymakers' promotion of HMO enrollment for Medicare beneficiaries during the 1990s proved to be a risk-ridden experience for all parties. Throughout the decade, policymakers, health plans, and Medicare beneficiaries were on a roller...

Hospitals' negotiating leverage with health plans: how and why has it changed?
February 1, 2003... Despite efforts to reduce hospital utilization and length of stay, hospital care continues to account for a substantial portion of total health care expenses (Levit et al. 2002; Agency for Healthcare Research and Quality 2000). In addition,...

Changes in hospital competitive strategy: a new medical arms race?
February 1, 2003... The strategies hospitals use to compete provide significant insight into broader health care market developments because hospital strategy is shaped by a variety of external forces. Some of the major external factors shaping hospital strategy...

Something old, something new: recent developments in hospital--physician relationships.
February 1, 2003... For more than a century, physicians in private practice in the United States maintained autonomy from hospitals, using the facilities as their "workshops" in mutually beneficial arrangements with no formal financial ties (Pauly and Redisch...

The resilience of the health care safety net, 1996-2001.
February 1, 2003... The safety net provides health care to the nation's 20 million low-income uninsured residents (1) regardless of their ability to pay for these services. While many providers care for some uninsured people, the safety net consists of the group...