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Medical care research and review : MCRR最新文献

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Underserved patients' perspectives on patient-centered primary care: does the patient-centered medical home model meet their needs? 服务不足的患者对以患者为中心的初级保健的看法:以患者为中心的医疗之家模式是否满足他们的需求?
IF 2.5
Medical care research and review : MCRR Pub Date : 2014-02-01 Epub Date: 2013-11-27 DOI: 10.1177/1077558713509890
Holly Mead, Ellie Andres, Marsha Regenstein
{"title":"Underserved patients' perspectives on patient-centered primary care: does the patient-centered medical home model meet their needs?","authors":"Holly Mead,&nbsp;Ellie Andres,&nbsp;Marsha Regenstein","doi":"10.1177/1077558713509890","DOIUrl":"https://doi.org/10.1177/1077558713509890","url":null,"abstract":"<p><p>The patient-centered medical home (PCMH) has gained significant interest as a delivery system model that can improve health care quality while reducing costs. This study uses focus groups to investigate underserved, chronically ill patients' preferences for care and develops a patient-centered framework of priorities. Seven major priorities were identified: (a) communication and partnership, (b) affordable care, (c) coordinated care, (d) personal responsibility, (e) accessible care, (f) education and support resources, and (g) the essential role of nonphysician providers in supporting their care. Using the framework, we analyzed the PCMH joint principals as developed by U.S. medical societies to identify where the PCMH model could be improved to better meet the needs of these patients. Four of the seven patient priorities were identified as not present in or supported by current PCMH joint principles. The study discusses how the PCMH model can better address the needs of low-income, disadvantaged patients. </p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"61-84"},"PeriodicalIF":2.5,"publicationDate":"2014-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558713509890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31912988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 25
The multiple causal pathways between performance measures' use and effects. 绩效指标的使用与效果之间的多重因果关系。
IF 2.5
Medical care research and review : MCRR Pub Date : 2014-02-01 Epub Date: 2013-07-22 DOI: 10.1177/1077558713496320
Damien Contandriopoulos, François Champagne, Jean-Louis Denis
{"title":"The multiple causal pathways between performance measures' use and effects.","authors":"Damien Contandriopoulos,&nbsp;François Champagne,&nbsp;Jean-Louis Denis","doi":"10.1177/1077558713496320","DOIUrl":"https://doi.org/10.1177/1077558713496320","url":null,"abstract":"<p><p>In recent decades, there has been a growing interest in the design and implementation of systems using public reporting of performance measures to improve performance. In their simplest form, such interventions rest on the market-based logic of consumers using publicly released information to modify their behavior, thereby penalizing poor performers. However, evidence from large-scale efforts to use public reporting of performance measures as an instrumental performance improvement tool suggests that the causal mechanisms involved are much more complex. This article offers a typology of four different plausible causal pathways linking public reporting of performance measures and performance improvement. This typology rests on a variety of conceptual models and a review of available empirical evidence. We then use this typology to discuss the core elements that need to be taken into account in efforts to use public reporting of performance measures as a performance improvement tool. </p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"3-20"},"PeriodicalIF":2.5,"publicationDate":"2014-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558713496320","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 34
Adoption of evidence-based clinical innovations: the case of buprenorphine use by opioid treatment programs. 采用循证临床创新:阿片类药物治疗方案使用丁丙诺啡的案例。
IF 2.5
Medical care research and review : MCRR Pub Date : 2014-02-01 Epub Date: 2013-09-18 DOI: 10.1177/1077558713503188
Christina M Andrews, Thomas A D'Aunno, Harold A Pollack, Peter D Friedmann
{"title":"Adoption of evidence-based clinical innovations: the case of buprenorphine use by opioid treatment programs.","authors":"Christina M Andrews,&nbsp;Thomas A D'Aunno,&nbsp;Harold A Pollack,&nbsp;Peter D Friedmann","doi":"10.1177/1077558713503188","DOIUrl":"https://doi.org/10.1177/1077558713503188","url":null,"abstract":"<p><p>This article examines changes from 2005 to 2011 in the use of an evidence-based clinical innovation, buprenorphine use, among a nationally representative sample of opioid treatment programs and identifies characteristics associated with its adoption. We apply a model of the adoption of clinical innovations that focuses on the work needs and characteristics of staff; organizations' technical and social support for the innovation; local market dynamics and competition; and state policies governing the innovation. Results indicate that buprenorphine use increased 24% for detoxification and 47% for maintenance therapy between 2005 and 2011. Buprenorphine use was positively related to reliance on private insurance and availability of state subsidies to cover its cost and inversely related to the percentage of clients who injected opiates, county size, and local availability of methadone. The results indicate that financial incentives and market factors play important roles in opioid treatment programs' decisions to adopt evidence-based clinical innovations such as buprenorphine use. </p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"43-60"},"PeriodicalIF":2.5,"publicationDate":"2014-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558713503188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31746765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 40
Knowledge of health insurance terminology and details among the uninsured. 未参保人员了解健康保险术语和细节。
IF 2.5
Medical care research and review : MCRR Pub Date : 2014-02-01 Epub Date: 2013-10-24 DOI: 10.1177/1077558713505327
Mary C Politi, Kimberly A Kaphingst, Matthew Kreuter, Enbal Shacham, Melissa C Lovell, Timothy McBride
{"title":"Knowledge of health insurance terminology and details among the uninsured.","authors":"Mary C Politi,&nbsp;Kimberly A Kaphingst,&nbsp;Matthew Kreuter,&nbsp;Enbal Shacham,&nbsp;Melissa C Lovell,&nbsp;Timothy McBride","doi":"10.1177/1077558713505327","DOIUrl":"https://doi.org/10.1177/1077558713505327","url":null,"abstract":"<p><p>By 2014, uninsured adults will be eligible for health insurance through exchanges with multiple plan options. Choosing health insurance is challenging even for those who have engaged in the process previously. We examined 51 uninsured adults' health insurance knowledge and preferences through semistructured qualitative interviews. Our sample was predominantly low-income and African American. Most had little or no experience with health insurance terminology. Those with limited health literacy skills understood less than those with higher health literacy. Many confused related insurance concepts. Non-health contexts (e.g., car insurance) aided understanding. Premiums, fixed costs, and specific coverage were rated very important to insurance decisions. Our study was one of the first to examine uninsured individuals' health insurance knowledge and preferences. Uninsured individuals may have different information needs and preferences than those studied in previous research. Clear information and familiar non-health contexts can be important strategies when communicating about the exchanges. </p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"85-98"},"PeriodicalIF":2.5,"publicationDate":"2014-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558713505327","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40267385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 63
Does expanding public insurance prevent material hardship for families with children? 扩大公共保险能防止有孩子的家庭出现物质困难吗?
IF 2.5
Medical care research and review : MCRR Pub Date : 2013-06-01 Epub Date: 2013-01-06 DOI: 10.1177/1077558712470566
Brendan Saloner
{"title":"Does expanding public insurance prevent material hardship for families with children?","authors":"Brendan Saloner","doi":"10.1177/1077558712470566","DOIUrl":"https://doi.org/10.1177/1077558712470566","url":null,"abstract":"<p><p>The 1997 Children's Health Insurance Program (CHIP) provided states with funding to expand public insurance to children in low-income families. Recent studies suggest CHIP improved family finances, but it is unknown whether CHIP specifically affected the prevalence of material hardships such as food and housing insecurity. This study uses cross-sectional data on low-income children from the National Survey of American Families (1997-2002) to examine the impact of CHIP on material hardships. Using an instrumental variable that exploits variation in income eligibility cutoffs across states and years, I find that households gaining CHIP eligibility did not experience significant changes in material hardship. CHIP significantly reduced the prevalence of postponed care for the subgroup of households close to the poverty line. For low-income families with children, public health insurance may play a larger role in increasing access to care than in supplementing the budget for necessities.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"267-86"},"PeriodicalIF":2.5,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558712470566","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40217271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
Variation in emergency department admission rates across the United States. 美国各地急诊科入院率的变化。
IF 2.5
Medical care research and review : MCRR Pub Date : 2013-04-01 Epub Date: 2013-01-06 DOI: 10.1177/1077558712470565
Jesse M Pines, Ryan L Mutter, Mark S Zocchi
{"title":"Variation in emergency department admission rates across the United States.","authors":"Jesse M Pines,&nbsp;Ryan L Mutter,&nbsp;Mark S Zocchi","doi":"10.1177/1077558712470565","DOIUrl":"https://doi.org/10.1177/1077558712470565","url":null,"abstract":"<p><p>There were more than 19 million hospitalizations in 2008 from hospital-based emergency departments (EDs), representing nearly 50% of all U.S. admissions. Factors related to variation in hospital-level ED admission rates are unknown. Generalized linear models were used to assess patient-, hospital-, and community-level factors associated with ED admission rates across a sample of U.S. hospitals using Healthcare Cost and Utilization Project data. In 1,376 EDs, the mean ED admission rate, when defined as direct admissions and also transfers from one ED to another hospital, was 17.5% and varied from 9.8% to 25.8% at the 10th and 90th percentiles. Higher proportions of Medicare and uninsured patients, more inpatient beds, lower ED volumes, for-profit ownership, trauma center status, and higher hospital occupancy rates were associated with higher ED admission rates. Also, hospitals in counties with fewer primary care physicians per capita and higher county-level ED admission rates had higher ED admission rates.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"218-31"},"PeriodicalIF":2.5,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558712470565","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40217270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 102
One fish, two fish, red fish, blue fish: effects of price frames, brand names, and choice set size on Medicare Part D insurance plan decisions. 一条鱼，两条鱼，红鱼，蓝鱼:价格框架，品牌名称和选择集大小对医疗保险D部分保险计划决策的影响。
IF 2.5
Medical care research and review : MCRR Pub Date : 2012-08-01 Epub Date: 2012-02-06 DOI: 10.1177/1077558711435365
Andrew J Barnes, Yaniv Hanoch, Stacey Wood, Pi-Ju Liu, Thomas Rice
{"title":"One fish, two fish, red fish, blue fish: effects of price frames, brand names, and choice set size on Medicare Part D insurance plan decisions.","authors":"Andrew J Barnes,&nbsp;Yaniv Hanoch,&nbsp;Stacey Wood,&nbsp;Pi-Ju Liu,&nbsp;Thomas Rice","doi":"10.1177/1077558711435365","DOIUrl":"https://doi.org/10.1177/1077558711435365","url":null,"abstract":"<p><p>Because many seniors choose Medicare Part D plans offering poorer coverage at greater cost, the authors examined the effect of price frames, brand names, and choice set size on participants' ability to choose the lowest cost plan. A 2×2×2 within-subjects design was used with 126 participants aged 18 to 91 years old. Mouselab, a web-based program, allowed participants to choose drug plans across eight trials that varied using numeric or symbolic prices, real or fictitious drug plan names, and three or nine drug plan options. Results from the multilevel models suggest numeric versus symbolic prices decreased the likelihood of choosing the lowest cost plan (-8.0 percentage points, 95% confidence interval=-14.7 to -0.9). The likelihood of choosing the lowest cost plan decreased as the amount of information increased suggesting that decision cues operated independently and collectively when selecting a drug plan. Redesigning the current Medicare Part D plan decision environment could improve seniors' drug plan choices.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"460-73"},"PeriodicalIF":2.5,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558711435365","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39968275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 22
Immigration and contract problems experienced by foreign-educated nurses. 留学护士的移民和合同问题。
IF 2.5
Medical care research and review : MCRR Pub Date : 2012-06-01 Epub Date: 2012-02-06 DOI: 10.1177/1077558711432890
Patricia Pittman, Carolina Herrera, Joanne Spetz, Catherine R Davis
{"title":"Immigration and contract problems experienced by foreign-educated nurses.","authors":"Patricia Pittman,&nbsp;Carolina Herrera,&nbsp;Joanne Spetz,&nbsp;Catherine R Davis","doi":"10.1177/1077558711432890","DOIUrl":"https://doi.org/10.1177/1077558711432890","url":null,"abstract":"<p><p>More than 8% of employed RNs licensed since 2004 in the United States were educated overseas, yet little is known about the conditions of their recruitment or the impact of that experience on health care practice. This study assessed whether the labor rights of foreign-educated nurses were at risk during the latest period of high international recruitment: 2003 to 2007. Using consensus-based standards contained in the Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Health Professionals to the United States, this study found 50% of actively recruited foreign-educated nurses experienced a negative recruitment practice. The study also found that nurses educated in low-income countries and nurses with high contract breach fees, were significantly more likely to report such problems. If, as experts believe may occur, the nursing shortage in the United States returns around 2014, oversight of international recruitment will become critically important to delivering high-quality health care to Americans.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"351-65"},"PeriodicalIF":2.5,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558711432890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39968219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 22
Variation in long-term acute care hospital use after intensive care. 重症监护后长期急性护理医院使用的变化。
IF 2.5
Medical care research and review : MCRR Pub Date : 2012-06-01 Epub Date: 2012-02-06 DOI: 10.1177/1077558711432889
Jeremy M Kahn, Rachel M Werner, Shannon S Carson, Theodore J Iwashyna
{"title":"Variation in long-term acute care hospital use after intensive care.","authors":"Jeremy M Kahn,&nbsp;Rachel M Werner,&nbsp;Shannon S Carson,&nbsp;Theodore J Iwashyna","doi":"10.1177/1077558711432889","DOIUrl":"https://doi.org/10.1177/1077558711432889","url":null,"abstract":"<p><p>Long-term acute care hospitals (LTACs) are an increasingly common discharge destination for patients recovering from intensive care. In this article the authors use U.S. Medicare claims data to examine regional- and hospital-level variation in LTAC utilization after intensive care to determine factors associated with their use. Using hierarchical regression models to control for patient characteristics, this study found wide variation in LTAC utilization across hospitals, even controlling for LTAC access within a region. Several hospital characteristics were independently associated with increasing LTAC utilization, including increasing hospital size, for-profit ownership, academic teaching status, and colocation of the LTAC within an acute care hospital. These findings highlight the need for research into LTAC admission criteria and the incentives driving variation in LTAC utilization across hospitals.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"339-50"},"PeriodicalIF":2.5,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558711432889","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39968222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 38
Pay for performance in health care: an international overview of initiatives. 卫生保健中的绩效薪酬:国际倡议概述。
IF 2.5
Medical care research and review : MCRR Pub Date : 2012-06-01 Epub Date: 2012-02-06 DOI: 10.1177/1077558711432891
Frank Eijkenaar
{"title":"Pay for performance in health care: an international overview of initiatives.","authors":"Frank Eijkenaar","doi":"10.1177/1077558711432891","DOIUrl":"https://doi.org/10.1177/1077558711432891","url":null,"abstract":"<p><p>Pay for performance (P4P) has become a popular approach to performance improvement in health care. Most of the P4P literature has focused on the United States and there is limited insight in the characteristics of major programs initiated in other countries. This article systematically describes and reviews P4P programs outside the United States. Our literature search identified 13 programs initiated in 9 countries. Although the programs share many similarities, they differ in several important respects, also when compared with the typical P4P program in the United States. In addition, there are clearly possibilities to increase incentive strength and minimize incentives for undesired behavior. In part, observed heterogeneity will be a consequence of contextual differences, but design choices often also seem to be made arbitrarily. In designing their programs, purchasers are hampered by limited knowledge of the influence of specific design choices and effective strategies to mitigate undesired behavior.</p>","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":" ","pages":"251-76"},"PeriodicalIF":2.5,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1077558711432891","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39968448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 153
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