Health Services Research articles from June 2008

Health Services Research archives from June 2008

Falling short: continued challenges in meeting the mental health needs of children with special health care needs.(Editorial)
June 1, 2008... Nearly one in every five households has a child with a special health care need (CSHCN), and at least one quarter of these children also has a mental health problem. These data underscore the fact that CSHCN have substantial unmet mental health...

Prescription drug coverage and effects on drug expenditures among elderly Medicare beneficiaries.(Medicare and the Elderly)
June 1, 2008... Innovations in medical technology, especially pharmaceuticals, have improved health outcomes and quality of life and have replaced surgeries and other invasive treatments. This shift has been one of the main drivers of the rapid growth of...

How do proxy responses and proxy-assisted responses differ from what Medicare beneficiaries might have reported about their health care?(Medicare and the Elderly)(Survey)
June 1, 2008... Surveys of the recipients of health care are increasingly important means of assessing the care provided by health plans, hospitals, physicians, and other entities (Lied et al. 2003; Tai-Seale 2004; Darby, Hays, and Kletke 2005). At the same...

The financial burden of overweight and obesity among elderly Americans: the dynamics of weight, longevity, and health care cost.(Medicare and the Elderly)(Report)
June 1, 2008... Approximately 35 percent of U.S. adults are overweight, and an additional 30 percent are obese (Flegal et al. 2002, 2004; Hedley et al. 2004). The increase in rates of overweight and obesity represents a major change in the biological and...

Relationship between state Medicaid policies, nursing home racial composition, and the risk of hospitalization for Black and White residents.(Medicaid and the Uninsured)
June 1, 2008... Racial disparities in the quality of nursing home (NH) care have been well documented. Black residents are less likely than their white counterparts to receive appropriate pharmacologic management for a myriad of conditions (Bernabei et al....

Medicaid managed care and the unmet need for mental health care among children with special health care needs.(Medicaid and the Uninsured)(Report)(Survey)
June 1, 2008... The proportion of the Medicaid population enrolled in managed care rose from 9.5 percent in 1991 to 60.7 percent in 2004 (Mitchell and Gaskin 2004; CMS 2005), reflecting states' decisions to convert Medicaid programs from traditional...

Medicaid undercount and bias to estimates of uninsurance: new estimates and existing evidence.(Medicaid and the Uninsured)(Survey)
June 1, 2008... There is consensus among researchers that population surveys of health insurance coverage undercount the number of individuals enrolled in Medicaid (Swartz and Purcell 1989; Holahan, Winterbottom, and Rajan 1995; Bennefield 1996; Dubay and...

Effects of poverty and lack of insurance on perceptions of racial and ethnic bias in health care.(Medicaid and the Uninsured)(Report)
June 1, 2008... Patients' perceptions of racial and ethnic bias and discrimination in health care are not uncommon among minority health care users. Based on national studies, as many as 15 percent of Latinos/Latinas and 12 percent of blacks report that they...

Examining variation in treatment costs: a cost function for outpatient methadone treatment programs.(Substance Abuse Treatment)(Report)
June 1, 2008... Although a substantial literature provides estimates of the total and per-patient costs for substance abuse treatment, relatively little is known about what drives these costs or why large variation in treatment costs is often observed across...

Role of state policies in the adoption of naltrexone for substance abuse treatment.(Substance Abuse Treatment)(Report)
June 1, 2008... The development of pharmaceutical agents to quell cravings has the potential to expand access to substance abuse treatment and improve treatment quality for alcohol and drug-dependent individuals. An estimated 19 million individuals...

Nonprice competition and quality of care in managed care: the New York SCHIP market.(Quality and Guidelines)(Survey)
June 1, 2008... The U.S. government is deeply involved in the health care market, and in the price control settings, one of the government's concerns is quality of care. Since managed care started expanding throughout the country in the 1980s, government and...

Hospital quality: a PRIDIT approach.(Quality and Guidelines)(Report)
June 1, 2008... Measuring and improving hospital quality is an important challenge in any attempt to improve the health care system. It is important because inpatient hospitals provide so much medical care (approximately $500 billion in 2003) (Hippisley-Cox et...

Evidence-based imaging guidelines and Medicare payment policy.(Quality and Guidelines)(Report)
June 1, 2008... Evidence-based medicine is a key component of recent efforts to improve the quality and cost-effectiveness of clinical practice. The past 20 years have seen the development and dissemination of numerous clinical guidelines, critical pathways,...

The staffing--outcomes relationship in nursing homes.(Nursing Homes)
June 1, 2008... The quality of care in nursing homes has long been an issue of concern to policy makers and the public. Following the Institute of Medicine report that documented serious abuses and quality of care problems (IOM 1986), intense scrutiny and...

Has the Medicare prospective payment system led to increased nursing home efficiency?(Nursing Homes)(Report)
June 1, 2008... The Medicare prospective payment system (PPS) for skilled nursing facility (SNF) reimbursement was implemented with the Balanced Budget Act (BBA) of 1997 in order to reduce nursing home costs and align reimbursement with resource intensity. The...

Shareholder value and the performance of a large nursing home chain.(Quality and Guidelines)(Report)
June 1, 2008... During the 1990s, the U.S. nursing home industry was transformed by the growth of large, multifacility corporations (chains) through successive mergers (Kitchener and Harrington 2004). Management researchers heralded this process of nursing...

Power of tests for a dichotomous independent variable measured with error.(Methods)(Report)
June 1, 2008... Health services researchers often face measurement errors in the independent variables they wish to use in regression models. In particular, analysts might not observe a dichotomous (or categorical) variable identifying group membership for...

The use of linear instrumental variables methods in health services research and health economics: a cautionary note.(Methods)(Report)
June 1, 2008... When analyzing data with the goal of informing health policy, the ability to draw true causal inference from the estimation results is of paramount importance. The typical health policy analysis focuses on identifying the effect that a...