Health Services Research articles from February 2007

Health Services Research archives from February 2007

Emergency departments in crisis: opportunities for research.
February 1, 2007... "If you can barely get through the night's 911 calls, how on earth can you handle a disaster?" asks Arthur L. Kellerman, M.D., a prominent emergency physician from Emory University. Although large-scale events such as the September 11...

The importance of population-based performance measures.(quality of healthcare)(Editorial)
February 1, 2007... Crossing the Quality Chasm, the landmark report issued by the Institute of Medicine, identified six aims to guide quality improvement efforts in health care--safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity--and...

Beyond our walls: impact of patient and provider coordination across the continuum on outcomes for surgical patients.(Quality and Outcomes)(Author abstract)(Clinical report)
February 1, 2007... Coordination of care factors critically in patient safety and care quality across services and settings (Institute of Medicine 2001). The existing research focuses on coordination of care within a single institution, usually a hospital (Argote...

Impact of the Medicare short stay transfer policy on patients undergoing major orthopedic surgery.
February 1, 2007... Since the implementation in 1983 of the acute care prospective payment system, hospitals have had a strong financial pressure to reduce costs. These cost reductions have been achieved primarily through reduced length of stay (LOS) (Meyers et...

Assigning ambulatory patients and their physicians to hospitals: a method for obtaining population-based provider performance measurements.(Quality and Outcomes)(Author abstract)
February 1, 2007... Concern about the uneven quality and rising costs of health care has led to growing interest in the development and adoption of performance measures for health care providers. The underlying theory is that performance measurement can foster...

Does ambulatory process of care predict health-related quality of life outcomes for patients with chronic disease?(Quality and Outcomes)(Author abstract)(Clinical report)
February 1, 2007... The validity of quality of care measurement has important implications for practicing clinicians, their patients, and all involved with health care delivery. The classic strategy for assessing the internal validity of quality of care measures...

Clinical practice guideline implementation strategy patterns in Veterans Affairs primary care clinics.
February 1, 2007... Clinical practice guidelines (CPGs) have been used increasingly to standardize diagnosis and treatment procedures based on the latest clinical evidence, and thereby improve the quality of care. The Veterans Health Administration (VHA), the...

Does type of gatekeeping model affect access to outpatient specialty mental health services?(Access and Disparities)(Author abstract)(Clinical report)
February 1, 2007... Managed care organizations (MCOs) use a variety of strategies to influence the type, quantity, costs, and quality of health care that their enrollees use. Utilization management (UM) is one major approach that includes gatekeeping arrangements,...

Effect of Medicaid Managed Care on racial disparities in health care access.(Access and Disparities)(Author abstract)
February 1, 2007... There is substantial evidence of racial disparities in health care access and utilization. Hispanics and African Americans are less likely than whites to have a regular primary care provider, and more likely to report emergency room (ER) use...

Analyzing multiple informant data from an evaluation of the health disparities collaboratives.
February 1, 2007... Health services researchers often collect similar or even identical data from multiple sources (e.g., physicians, nurses, patients, teachers, parents) in order to increase the reliability of the measurements or to gain insights from several...

Treatment for ADHD: is more complex treatment cost-effective for more complex cases?(Treatment and Costs)(Author abstract)(Clinical report)
February 1, 2007... Attention problems are among the most common of mental/emotional/behavioral disorders among children and youth (U.S. Department of Health and Human Services 1999). Youth with attention deficit hyperactivity disorder (ADHD) are more likely to be...

Use of aggressive medical treatments near the end of life: differences between patients with and without dementia.(Treatment and Costs)(Author abstract)
February 1, 2007... In many areas of health care large disparities exist in terms of who does and does not receive certain procedures or types of treatment. Disparities have been shown to exist along the lines of age (Stone et al. 1996; Levinsky et al. 2001;...

The boomers are coming: a total cost of care model of the impact of population aging on health care costs in the United States by major practice category.(Treatment and Costs)(Author abstract)
February 1, 2007... Our work models the impact of population aging on health care costs in the United States over the next five decades, at an aggregate and clinical level. In the context of many years of increasing health care costs, future cost concerns have...

Revisiting the relationship between managed care and hospital consolidation.
February 1, 2007... During the 1990s, managed care displaced indemnity insurance to become the dominant form of health insurance in the private sector (Glied 2000). Over the same period, a wave of hospital mergers, acquisitions, and hospital system expansions...

Health care markets, the safety net, and utilization of care among the uninsured.
February 1, 2007... Over the past 15 years, roughly one in seven individuals in the U.S. (between 13.6 and 16.3 percent of the population) have been uninsured (U.S. Census Bureau 2004). For many of the uninsured, access to health care is heavily dependent on a...

Identifying affordable sources of medical care among uninsured persons.(Health Insurance)
February 1, 2007... Objective. To examine the effects of policy, health system, and sociodemographic characteristics on the likelihood that uninsured persons pay a lower price at their regular source of care, or that they are aware of lower priced providers in...

Immigrants and employer-sponsored health insurance.(Author abstract)
February 1, 2007... Interest in the health status of immigrant populations has increased dramatically in response to their rapid growth over the past two decades. More immigrants came to live in the U.S. in the 1990s than in any other decade in the nation's...

Preparing and presenting effective research posters.(health care)
February 1, 2007... An assortment of posters is a common way to present research results to viewers at a professional conference. Too often, however, researchers treat posters as poor cousins to oral presentations or published papers, failing to recognize the...

Defining interdisciplinary research: conclusions from a critical review of the literature.
February 1, 2007... As scientific knowledge in a wide range of disciplines has advanced, scholars have become increasingly aware of the need to link disciplinary fields to more fully answer critical questions, or to facilitate application of knowledge in a...

Putting the consumer first: an introduction and overview.
February 1, 2007... If anything best describes recent trends in the complex world of long-term care (LTC), it is the growth of interest and investment in home and community-based services (HCBS). Various forces have driven efforts to shift from disproportionate...

The public/private partnership behind the Cash and Counseling Demonstration and Evaluation: its origins, challenges, and unresolved issues.(Author abstract)
February 1, 2007... For the past 30 years, a quiet, persistent revolution has gathered steam and shaped America's thinking about how to care for people with disabilities. Before the 1970s, the vast majority of physically and cognitively impaired elders and younger...

Designing the Cash and Counseling demonstration and evaluation.(Medicaid program)
February 1, 2007... Coverage of personal assistance services for Medicaid program participants with long-term functional disabilities has been available since the late 1960s, but, during the 1980s, coverage options were expanded and more states elected to offer...

Commonalities and variations in the Cash and Counseling programs across the three demonstration states.
February 1, 2007... In Arkansas, Florida, and New Jersey, Cash and Counseling was offered as an alternative to traditional, case-managed supportive services in which individuals with disabilities receive personal care from agency employees, who are previously...

The research design and methodological issues for the Cash and Counseling evaluation.(Author abstract)
February 1, 2007... The Cash and Counseling evaluation described why individuals chose to participate in the demonstration, how the three demonstration states (Arkansas, Florida, and New Jersey) implemented their programs, and how each state's program affected...

Consumer enrollment and experiences in the Cash and Counseling program.
February 1, 2007... Medicaid supportive services, traditionally prescribed by physicians and provided by home care agencies under nurse supervision, help recipients with activities such as bathing, using the toilet, meal preparation, and light housework. The...

Effects of Cash and Counseling on personal care and well-being.(Author abstract)
February 1, 2007... Medicaid beneficiaries who have disabilities and receive supportive services from home care or case management agencies often have little control over who provides their care, when they receive it, and how it is delivered. Under Cash and...

How does Cash and Counseling affect costs?(Author abstract)
February 1, 2007... The Cash and Counseling Demonstration and Evaluation was designed to assess whether a new, consumer-directed manner of obtaining personal care services (PCS) or home and community based services (HCBS) could improve the outcomes of...

How caregivers and workers fared in Cash and Counseling.(Author abstract)
February 1, 2007... In light of evidence that Cash and Counseling improved beneficiary satisfaction and quality of life, this paper examines how the model worked for two other important groups: (1) the family and friends providing the most unpaid assistance to...

Case histories of six consumers and their families in Cash and Counseling.(Cash and Counseling Demonstration and Evaluation)(Case study)
February 1, 2007... CASE HISTORIES OF SIX CONSUMERS AND THEIR FAMILIES IN CASH AND COUNSELING This paper examines the case histories of six consumers and their caregivers in order to better understand how individual lives were affected by the Cash and...

The future of Cash and Counseling: the framers' view.
February 1, 2007... The Supreme Court's 1999 Olmstead decision made it clear that state long-term care systems must provide a continuum of services that allows people to live where and how they want. But how do we achieve this reform? Cash and Counseling...

Commentary: Cash and Counseling in an international context.
February 1, 2007... Health and long-term care policy in the United States is almost always carried out without knowledge of how other countries address similar problems. American public policy is the poorer for this ethnocentrism because other countries often have...

Commentary: social experimentation at its best: the Cash and Counseling demonstration and its implications.
February 1, 2007... The Cash and Counseling demonstration was the most significant long-term care policy experiment undertaken in more than a decade. It is an archetypal example of the ability of research to play an important role in public policy (Kemper 2003)....