Health Services Research articles from October 2008

Health Services Research archives from October 2008

Reflections on improving hospital performance.(Editorial)(Editorial)
October 1, 2008... The juxtaposition of preparing an editorial for the October 2008 volume of Health Services Research (HSR) based on several studies about performance measures in healthcare organizations and participating in the hectic last weeks of Marie-Claire...

Does hospital performance on process measures directly measure high quality care or is it a marker of unmeasured care?(Healthcare Organizational Performance Measures)(Clinical report)
October 1, 2008... Because measuring quality is seen as essential to improving it, quality is measured, and in many cases reported, for hospitals, health plans, nursing homes, home health agencies, and physicians. These efforts are intended to provide benchmarks...

A comparative study of quality outcomes in freestanding ambulatory surgery centers and hospital-based outpatient departments: 1997-2004.(Healthcare Organizational Performance Measures)(Report)
October 1, 2008... Over the past few decades, several factors including improvements in medical technology, anesthesia, and pain management have facilitated the push of surgical services to outpatient facilities (Medicare Payment Advisory Commission [MedPAC]...

Does doctor-patient communication affect patient satisfaction with hospital care? Results of an analysis with a novel instrumental variable.(Healthcare Organizational Performance Measures)
October 1, 2008... Patients' satisfaction with their hospital care is important to payers, hospital administrators, physicians, and patients. It is important because it captures the patients' experience of health care outside of direct effects on health and...

Do bonding, bridging, and linking social capital affect preventable hospitalizations?(Consumer Issues in Healthcare)(Report)
October 1, 2008... Community-level factors have been associated with access to health care, above and beyond covariates such as individual health status, insurance coverage, and sociodemographics. For example, previous research has found that neighborhood is...

Effects of a consumer driven health plan on pharmaceutical spending and utilization.(Consumer Issues in Healthcare)(Report)
October 1, 2008... For the last 15 years, pharmaceutical expenditures in the United States have increased faster than those in other major medical sectors. Insurers have introduced different strategies to moderate this cost explosion. One mechanism is to increase...

Potential savings from an evidence-based consumer-oriented public education campaign on prescription drugs.(Consumer Issues in Healthcare)(Report)
October 1, 2008... Prescription drug expenditures have grown as a share of total health expenditures from 8.1 percent in 1997 to 12.1 percent in 2005, with per person spending doubling over this same period (Catlin et al. 2007; Zuvekas and Cohen 2007)....

Effect of prescription drug coverage on health of the elderly.(Insurance Coverage and Healthcare)(Report)
October 1, 2008... In 2003, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) established a prescription drug benefit for the Medicare population. The program, which started in January 2006, provides prescription drug insurance through...

Selection bias and utilization of the dual eligibles in Medicare and Medicaid HMOs.(Insurance Coverage and Healthcare)(health maintenance organizations)(Medicaid-managed care program)(Report)
October 1, 2008... Medicare and Medicaid "dual eligibles" are among the frailest and costliest medical populations in the United States. Dual eligibles often are disadvantaged by the perverse payment mechanisms and fragmented care systems of the Medicare and...

The impact of gaps in health insurance coverage on immunization status for young children.(Insurance Coverage and Healthcare)
October 1, 2008... The Centers for Disease Control and Prevention (CDC) announced in July 2005 that childhood immunization coverage for children aged 19-35 months was at an all time high. Childhood immunizations for the baseline series of vaccines (4:3:1:3:3)...

Targeting primary care referrals to smoking cessation clinics does not improve quit rates: implementing evidence-based interventions into practice.(Changing Practices: Models and Evidence)(Clinical report)
October 1, 2008... Tobacco use is the leading preventable cause of mortality, accounting for 435,000 deaths in the United States (Mokdad et al. 2004) and 4.8 million deaths due to tobacco worldwide (Ezzati and Lopez 2003). In the United States alone, smoking is...

Decision-analytic modeling to assist decision making in organizational innovation: the case of shared care in hearing aid provision.(Changing Practices: Models and Evidence)(Report)
October 1, 2008... Health technology assessment focuses increasingly more on organizational innovations than on specific technologies. With regard to decision making in organizational innovation there are two major issues: (1) there is not enough data to answer...

How many nurses per patient? Measurements of nurse staffing in health services research.(Methods)
October 1, 2008... Numerous research reports have examined patterns of nurse staffing (Aiken, Sochalski, and Anderson 1996; Unruh, Fottler, and Talbott 2003; Aydin et al. 2004) and the relationship between nurse staffing and patient outcomes (Aiken et al. 2002;...

Experimental health insurance estimates for low-income and demographic groups by state.(Methods)
October 1, 2008... Since 1987, the Census Bureau has published state uninsured rates as part of the Current Population Reports series. Estimates for children under age 19 who are at or below 200 percent of the federal poverty level, all children aged 0-17, people...

Comparison of web-based versus paper-and-pencil self-administered questionnaire: effects on health indicators in Dutch adolescents.(Methods)(Survey)
October 1, 2008... Because of the many advantages, computerized questionnaires are used more often in youth surveys, replacing the more traditional paper-and-pencil (p&p) questionnaires. Advantages of computerized questionnaires are, for instance, the possibility...

A new method for estimating race/ethnicity and associated disparities where administrative records lack self-reported race/ethnicity.(Methods)(Report)
October 1, 2008... Efforts to measure, monitor, and address racial/ethnic disparities in health care have been limited by the paucity of data regarding the race/ethnicity of users of the health care system. Indeed, until recently, many viewed the collection of...

Rural veterans and access to high-quality care for high-risk surgeries.(Research Briefs)(Report)
October 1, 2008... Many veterans enrolled in the Veterans Health Administration (VA) also obtain health care from non-VA providers (Wright et al. 1997, 1999; Weeks et al. 2005a, 2002, 2003, 2006), particularly if they live far from VA care (Lahiri and Xing 2004;...

Early stage breast cancer treatments for younger Medicare beneficiaries with different disabilities.(Research Briefs)(Report)
October 1, 2008... Government officials, including the U.S. Surgeon General, and patient advocates have called for including persons with disabilities in treatment disparity studies (U.S. Department of Health and Human Services 2000, 2005). Growing numbers of...

Cancer incidence in elderly Medicare and dually eligible beneficiaries.(Research Briefs)(Clinical report)
October 1, 2008... Cancer incidence among elderly (defined as age 65 years and older) white and black patients who are dually insured with Medicare and Medicaid versus Medicare alone is the target of this investigation. Individuals that simultaneously receive...

Improving efficiency and value in health care: introduction.(Editorial)(Editorial)
October 1, 2008... The Agency for Healthcare Research and Quality (AHRQ) is pleased to sponsor the first theme issue for Health Services Research (HSR), a new feature whereby excellent and ground-breaking health services research will be gathered around an...

Examining quality improvement programs: the case of Minnesota hospitals.(RESEARCH ARTICLE)(Report)
October 1, 2008... Over $2 trillion was spent on health care in the United States in 2006, the highest level of per capita spending in the world. With health insurance premiums doubling every 5 years, it is predicted that a family's annual costs for health...

Front-line staff perspectives on opportunities for improving the safety and efficiency of hospital work systems.(RESEARCH ARTICLE)(Report)
October 1, 2008... Hospitals face a daunting challenge: providing safe, effective care in complex organizations strapped by heavy patient loads, limited staffing, and shrinking financial resources. Hospitals are improving their ability to provide safe, effective...

Hospital quality, efficiency, and input slack differentials.(RESEARCH ARTICLE)
October 1, 2008... Much is yet to be learned about the interaction of cost, efficiency, and quality. It is not clear that cost containment and quality improvement are mutually consistent objectives. Quality improvement can result in greater resource use because...

Steering patients to safer hospitals? The effect of a tiered hospital network on hospital admissions.(RESEARCH ARTICLE)(Report)
October 1, 2008... Recent innovations in health insurance products and health financing mechanisms are attempting to address the escalation of health costs and the mounting evidence of problems with health care quality and safety in the United States. These...

Specialty and full-service hospitals: a comparative cost analysis.(RESEARCH ARTICLE)
October 1, 2008... During the last 25 years, the U.S. hospital industry has undergone dramatic changes in its competitive landscape. Such changes include the consolidation of independent hospitals into systems, the rise of a proprietary sector, a marked shift...

Access intervention in an integrated, prepaid group practice: effects on primary care physician productivity.(RESEARCH ARTICLE)(Report)
October 1, 2008... This paper presents one part of the evaluation of Group Health Cooperative's (GHC) Access Initiative, an organizational innovation designed to improve access to improve quality (Ralston et al. in press). The Initiative's broad goal is to...

Impact of physician assistant care on office visit resource use in the United States.(RESEARCH ARTICLE)(Report)
October 1, 2008... BACKGROUND AND RATIONALE The physician assistant (PA) profession has grown dramatically in recent years, with the number of practicing PAs tripling from about 20,000 in 1991 to over 68,000 in 2008 (American Academy of Physician Assistants...